Test can predict success of IVF: U.S. report
U.S. researchers have developed a formula that can predict whether fertility treatment will succeed more accurately than using age alone, and used it to develop a commercial test.
They said their test, published in the Proceedings of the National Academy of Sciences on Monday, could save couples the agony and expense of multiple attempts to have babies using in vitro fertilization, also known as IVF.
Surprisingly, they said, the test showed that couples who would have been discouraged from trying again using traditional assessments were actually likely to succeed.
In IVF, egg and sperm are united in a lab dish and resulting embryos are implanted into the mother's uterus to grow. Predicting whether it will work is tricky and doctors rely heavily on a woman's age.
A team lead by Dr. Mylene Yao of Stanford University in California, decided to look at dozens of factors, including age but also looking at how well and how fast the embryos grow, a woman's hormonal response to the treatment and the condition of her uterus when the embryo is implanted.
They used data from more than 5,000 IVF cycles performed at Stanford Hospital from 2003 to 2008 and matched it to success rates.
"Since this model uses clinical data from a previously failed IVF attempt, a first IVF treatment can be viewed both as an infertility treatment and as a potential prognostic tool for future cycles," Yao said in a statement.
As many as 80 million couples worldwide and 7.2 million in the United States are infertile. The infertility market is large and growing with an estimated 140,000 IVF cycles in the United States in 2008.
That accounts for about 2 percent of infertile couples, Yao's team said. About 1 percent of U.S. newborns were conceived using IVF, the researchers said, and a million babies have been born using IVF globally since Louise Brown, the first "test tube" baby, was born in Britain in 1978.
Yao and colleagues have founded a new company called Univfy to develop and commercialize the test. The company has licensed the technology from Stanford and has applied for a patent. It is seeking U.S. Food and Drug Administration approval to market the test by this fall.
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Childbirth is the process whereby an infant is born. It is considered by many to be the beginning of the infant's life, and age is defined relative to this event in most cultures.
A woman is considered to be in labour when she begins experiencing regular uterine contractions, accompanied by changes of her cervix — primarily effacement and dilation. While childbirth is widely experienced as painful, some women do report painless labours, while others find that concentrating on the birth helps to quicken labour and lessen the sensations. Most births are successful vaginal births, but sometimes complications arise and a woman may undergo a cesarean section.
During the time immediately after birth, both the mother and the baby are hormonally cued to bond, the mother through the release of oxytocin, a hormone also released during breastfeeding.
Parents Can Help Limit Kids’ Exposure to Medical Imaging
Outdoor summer fun can sometimes lead to falls and injuries in children, so parents would be wise to get informed about the use of medical imaging tests before an emergency occurs that requires X-rays or CT scans, an expert says.
Recent media reports about high levels of ionizing radiation associated with frequent use of CT scans may cause parents to be concerned about the safety of radiology and imaging tests in children, noted Dr. Helene Pavlov, radiologist-in-chief at the Hospital for Special Surgery in New York City, in a news release from the hospital.
Because children are still growing, their bodies are more susceptible than adults to the effects of ionizing radiation, so it's important to limit children's exposure, Pavlov explained. Parents should ask if their hospital emphasizes ALARA, the acronym for "as low as reasonably achievable" with regard to ionizing radiation, she suggested.
Before agreeing to an imaging examination for a child, Pavlov advises parents to keep the following points in mind:
- Ask what the doctor believes is the problem and whether it's possible to use a non-ionizing radiation imaging method such as MRI or ultrasound for diagnosis.
- Ensure that the radiation technologist shields the child and confines the areas being exposed to ionizing radiation.
- Ask if the technique being used has been adjusted to the size of the child.
- Ask about "repeat rates" -- that is, how often an image needs to be repeated because of excessive motion, incorrect positioning or improper technique. If a hospital's repeat rate is high, parents may want to consider a different imaging center for their child's examination, Pavlov suggested.
- It's also a good idea for parents to ask how many children undergo medical imaging tests at a facility. The higher the percentage of children, the more experience the imaging team has in achieving a correct image on the first attempt.
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The expected date of delivery (EDD) is 40 weeks counting from the first day of the last menstrual period (LMP), and birth usually occurs between 37 and 42 weeks.[10] The actual pregnancy duration is typically 38 weeks after conception. Though pregnancy begins at conception, it is more convenient to date from the first day of a woman's last menstrual period, or from the date of conception if known. Starting from one of these dates, the expected date of delivery can be calculated. Forty weeks is 9 months and 6 days, which forms the basis of Naegele's rule for estimating date of delivery. More accurate and sophisticated algorithms take into account other variables, such as whether this is the first or subsequent child (i.e., pregnant woman is a primip or a multip, respectively), ethnicity, parental age, length of menstrual cycle, and menstrual regularity.
Pregnancy is considered "at term" when gestation attains 37 complete weeks but is less than 42 (between 259 and 294 days since LMP). Events before completion of 37 weeks (259 days) are considered preterm; from week 42 (294 days) events are considered postterm.[11] When a pregnancy exceeds 42 weeks (294 days), the risk of complications for woman and fetus increases significantly.[10][12] As such, obstetricians usually prefer to induce labour, in an uncomplicated pregnancy, at some stage between 41 and 42 weeks.[13][dead link][14]
Recent medical literature prefers the terminology preterm and postterm to premature and postmature. Preterm and postterm are unambiguously defined as above, whereas premature and postmature have historical meaning and relate more to the infant's size and state of development rather than to the stage of pregnancy.[15][16]
Fewer than 5% of births occur on the due date; 50% of births are within a week of the due date, and almost 90% within 2 weeks.[17] It is much more useful and accurate, therefore, to consider a range of due dates, rather than one specific day, with some online due date calculators providing this information.
Accurate dating of pregnancy is important, because it is used in calculating the results of various prenatal tests (for example, in the triple test). A decision may be made to induce labour if a fetus is perceived to be overdue. Furthermore, if LMP and ultrasound dating predict different respective due dates, with the latter being later, this might signify slowed fetal growth and therefore require closer review.
The age of viability has been receding because of continued medical progress. Whereas it used to be 28 weeks, it has been brought back to as early as 23, or even 22 weeks in some countries. Unfortunately, there has been a profound increase in morbidity and mortality associated with the increased survival to the extent it has led some to question the ethics and morality of resuscitating at the edge of viability.
Giving Kids Booze, Medicines Can Be Child Abuse
The malicious use of alcohol and medicines is an under-recognized form of child abuse, according to a new report.
The U.S. study reviewed cases of pharmaceutical-related child abuse reported to the National Poison Data System between 2000 and 2008. The cases included the use of alcohol, painkillers, cough and cold medicines, sedatives, sleeping pills and antipsychotic medicines.
The findings are scheduled to be published in an upcoming issue of the Journal of Pediatrics.
The review included over 1,400 cases, and nearly 14 percent led to moderate or major consequences for children, including death. In about half of the cases, children were given at least one sedative. On average, 160 cases of pharmaceutical abuse, including two deaths, were reported each year.
Motives for this type of child abuse included punishment, amusement, or a desire for a break from childcare responsibilities, the researcher pointed out in a news release from the journal's publisher.
The findings highlight a serious problem, according to study author Dr. Shan Yin, of the University of Colorado and the Rocky Mountain Poison and Drug Center at Denver Health.
"The malicious administration of pharmaceuticals should be considered an important form of child abuse," Yin stated in the news release.
Pediatricians and emergency medical personnel should be on alert for this type of child abuse, and comprehensive drug screening should be used for children who are suspected victims of abuse, Yin added.
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Prenatal defines the period occurring "around the time of birth", specifically from 22 completed weeks (154 days) of gestation (the time when birth weight is normally 500 g) to 7 completed days after birth.[9]
Legal regulations in different countries include gestation age beginning from 16 to 22 weeks (5 months) before birth.
Damage From Binge-Drinking in Pregnancy Worsens With Age
Older women who binge-drink when pregnant are at higher risk for having children with permanent alcohol-related brain damage, new research finds.
Children of pregnant women 30 or older who binge-drink are more likely to suffer greater damage from Fetal Alcohol Spectrum Disorders (FASD), a group of birth defects that includes irreversible physical and mental disorders as well as permanent mental retardation, the study says.
The findings are reported online in advance of print publication in the October issue of Alcoholism: Clinical & Experimental Research.
"Our finding that children born to older drinking mothers have more alcohol-related attention deficits than children born to younger drinking women is consistent with prior studies," Lisa M. Chiodo, an assistant professor in the college of nursing at Wayne State University, said in a journal news release.
"Although not conclusive, this finding may be due to older moms drinking for longer periods, greater alcohol tolerance, and having more alcohol-related health problems -- all leading to higher levels of alcohol in their fetuses," Chiodo said. "It has also been suggested that changes in body size, metabolism or composition, or number of births, which are all related to maternal age, may be factors increasing the impact of prenatal alcohol exposure."
The study involved 462 children -- divided equally between boys and girls -- who were born to inner-city women recruited while they were pregnant. The researchers examined binge drinking, smoking, cocaine, marijuana and opiate use during pregnancy.
Tracking the offspring of the women up to the age of 7, the authors conducted performance tests to assess attention skills at the study's conclusion.
The team found that those children born to mothers 30 years or older who engaged in binge drinking while pregnant had more attention deficit issues that those born to the younger mothers. Those born to the older moms were found to make more errors on the completed tests and tended to respond to questions more cautiously and slowly.
Researchers said the findings had implications for prevention efforts and training programs for children damaged by exposure to alcohol in the womb.
The National Women's Health Information Center warns that there is no safe level of alcohol consumption during pregnancy, and that women who are pregnant should not drink at all.
Related info :
Pregnancy occurs as the result of the female gamete or oocyte merging with the male gamete, spermatozoon, in a process referred to, in medicine, as "fertilization", or more commonly known as "conception". After the point of fertilization, it is referred to as a zygote or fertilized egg. The fusion of male and female gametes usually occurs through the act of sexual intercourse, resulting in spontaneous pregnancy. However, the advent of artificial insemination and in vitro fertilisation have also made achieving pregnancy possible in cases where sexual intercourse does not result in fertilization (e.g., through choice or male/female infertility).
Moderate Caffeine Intake Safe During Pregnancy, Experts Say
Women can drink a cup of coffee or one soft drink a day during pregnancy and not worry that it might put them at risk of miscarriage or preterm birth, according to new guidelines released by the American College of Obstetricians and Gynecologists.
The professional group issued the information from its Committee on Obstetric Practice, which reviewed studies on the topic before making a decision.
"Finally, we have good evidence to show that having a cup of coffee a day is fine and it poses no risk to the fetus," said Dr. William H. Barth Jr., chairman of the committee on obstetric practice and chief of the division of maternal-fetal medicine at Massachusetts General Hospital in Boston.
They are talking about a reasonably sized cup of coffee or serving of soda, of course.
After the committee reviewed the published medical literature, they found no link between moderate intake of caffeine -- defined as less than 200 milligrams (mg) per day -- and either miscarriage or preterm birth.
The experts can't say for sure whether caffeine intake during pregnancy restricts fetal growth. And they have no conclusion about the effects of higher levels of caffeine and miscarriage risk.
As for higher levels, "we just don't know," Barth said. "Some studies have suggested a higher rate of miscarriage with higher levels of caffeine; others not."
To put things in perspective, an 8-ounce cup of brewed, drip coffee averages 137 mg of caffeine, according to the group, while an 8-ounce cup of instant coffee has 76 mg. A 12-ounce soft drink has 37 mg of caffeine and an 8-ounce cup of chocolate milk has 5 mg to 8 mg.
The committee's opinion is published in the August issue of Obstetrics & Gynecology.
Another expert, Dr. Gene Burkett, a professor of obstetrics and gynecology at the University of Miami Miller School of Medicine, reviewed the same evidence as the committee and said the new opinion makes sense.
"If you take less than 200 milligrams of caffeine, it does no harm," he said. "There is not data to suggest that a cup of coffee will hurt anyone."
"Anything in moderation is reasonable, and I think one cup of coffee is moderate," he said.
For the review, Barth and the other committee members found two recent studies that saw no significant increase in miscarriage risk with levels of caffeine intake at less than 200 mg daily.
They also found two large studies that looked at any relationship between caffeine intake and preterm birth, and neither found a link between moderate intake of caffeine and early delivery.
Miscarriage is defined as a spontaneous loss of a pregnancy before 20 weeks; most occur, experts say, because a fetus isn't developing normally.
About 15 percent to 20 percent of pregnancies end in miscarriage, according to the group, and often within the first 13 weeks. Symptoms can include spotting or bleeding without pain, or heavy persistent bleeding with pain and cramping.
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One scientific term for the state of pregnancy is gravid, and a pregnant female is sometimes referred to as a gravida.[1] Neither word is used in common speech. Similarly, the term "parity" (abbreviated as "para") is used for the number of previous successful live births. Medically, a woman who has never been pregnant is referred to as a "nulligravida", a woman who is (or has been only) pregnant for the first time as a "primigravida"[2], and a woman in subsequent pregnancies as a multigravida or "multiparous".[1][3][4] Hence, during a second pregnancy a woman would be described as "gravida 2, para 1" and upon live delivery as "gravida 2, para 2". An in-progress pregnancy, as well as abortions, miscarriages, or stillbirths account for parity values being less than the gravida number, whereas a multiple birth will increase the parity value. Women who have never carried a pregnancy achieving more than 20 weeks of gestation age are referred to as "nulliparous".[5]
The term embryo is used to describe the developing offspring during the first 8 weeks following conception, and the term fetus is used from about 2 months of development until birth.[6][7]
In many societies' medical or legal definitions, human pregnancy is somewhat arbitrarily divided into three trimester periods, as a means to simplify reference to the different stages of prenatal development. The first trimester carries the highest risk of miscarriage (natural death of embryo or fetus). During the second trimester, the development of the fetus can be more easily monitored and diagnosed. The beginning of the third trimester often approximates the point of viability, or the ability of the fetus to survive, with or without medical help, outside of the uterus.[8]
Some caffeine okay during pregnancy: obstetricians
A cup of coffee a day during pregnancy probably won't increase a woman's risk of miscarriage or premature birth, The American College of Obstetricians and Gynecologists said today.
Until recently, studies have had conflicting findings about the effect of moderate caffeine consumption on pregnancy complications.
But, "I think it's time to comfortably say that it's okay to have a cup of coffee during pregnancy," Dr. William Barth, the chair of a College committee which reviewed the evidence, told Reuters Health.
The College's Committee on Obstetric Practice said that 200 milligrams of caffeine a day, about the amount in a 12-ounce cup of coffee, doesn't significantly contribute to miscarriages or premature births. That definition of "moderate caffeine consumption" would also include drinking about four 8-ounce cups of tea or more than five 12-ounce cans of soda a day, or eating six or seven dark chocolate bars.
The committee said the evidence was not clear on whether consuming more than 200 mg of caffeine a day might increase pregnancy risks.
The group considered two recent studies, each of which followed more than 1,000 pregnant women. One study, led by Dr. David Savitz of The Mount Sinai Medical Center in New York, found no increased rate of miscarriage for women who consumed low, moderate, or high levels of caffeine at different points in their pregnancy.
In the other, Dr. De-Kun Li and his colleagues at Kaiser Permanente's Division of Research in Oakland found a higher risk of miscarriage in women who consumed more than 200 mg of caffeine per day, but no extra risk at lower levels.
The committee also pointed to two other studies that found that a mother's moderate caffeine intake did not make it any more likely she would deliver a baby prematurely.
Research has shown that caffeine is able to cross the placenta, which led to worries that it could cause miscarriage or premature birth. "It's not inert, it does have drug-like properties," Savitz, who was not involved in producing the guidelines, told Reuters Health. And, he said, "it justifiably deserves a close look because it's so widely used."
In the U.S., about 16 percent of all pregnancies end in miscarriage and about 12 percent of babies are born prematurely.
Previous studies, Barth said, were mixed and unclear about the link between caffeine and pregnancy risks. It was the new findings from large groups of women that allowed the committee to feel confident that moderate caffeine intake was safe, and "try to bring some conclusion to the subject," he said.
The committee statement goes along with the thinking that caffeine is "not an all-or-nothing sort of thing," Savitz said. While some women may choose to cut out caffeine altogether during pregnancy, others might care a lot about that daily cup of coffee and just try to cut back a little - and both options are okay, he said.
Li said that while the committee report is balanced, he would recommend erring on the side of safety - even for low levels of caffeine consumption.
The committee's opinion could help women make choices during pregnancy, Savitz said. "It's not either shocking or alarmist or changing radically what we thought before," he said. "But sometimes I think it's important for authoritative groups to issue these kinds of statements. I think it can be a helpful guideline to physicians and I also think it can be helpful to women themselves."
Related info :
Pregnancy is the carrying of one or more offspring, known as a fetus or embryo, inside the womb of a female. In a pregnancy, there can be multiple gestations, as in the case of twins or triplets. Human pregnancy is the most studied of all mammalian pregnancies. Childbirth usually occurs about 38 weeks after conception; i.e., approximately 40 weeks from the last normal menstrual period (LNMP) in humans. The World Health Organization defines normal term for delivery as between 37 weeks and 42 weeks.
Record number of children getting HIV drugs: WHO
Life-saving drugs that quell HIV reached a record 355,000 children at the end of last year, compared with 276,000 a year earlier, but more young lives could be saved if antiretroviral treatment began earlier, the World Health Organisation (WHO) said on Tuesday.
The figures were released at the 18th International AIDS Conference in Vienna, where more than 20,000 scientists, policymakers and grassroots workers in AIDS are meeting until Friday.
More than 33 million people around the world have the human immunodeficiency virus (HIV) which causes AIDS, according to UN estimates for 2008.
In that year, 2.7 million people became infected, 400,000 of them children aged under 15.
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The beginning of pregnancy[18] may be detected in a number of different ways, either by a pregnant woman without medical testing, or by using medical tests with or without the assistance of a medical professional.
Most pregnant women experience a number of symptoms[19] , which can signify pregnancy. The symptoms can include nausea and vomiting, excessive tiredness and fatigue, craving for certain foods not normally considered a favorite, and frequent urination particularly during the night.
A number of early medical signs are associated with pregnancy.[20][21] These signs typically appear, if at all, within the first few weeks after conception. Although not all of these signs are universally present, nor are all of them diagnostic by themselves, taken together they make a presumptive diagnosis of pregnancy. These signs include the presence of human chorionic gonadotropin (hCG) in the blood and urine, missed menstrual period, implantation bleeding that occurs at implantation of the embryo in the uterus during the third or fourth week after last menstrual period, increased basal body temperature sustained for over 2 weeks after ovulation, Chadwick's sign (darkening of the cervix, vagina, and vulva), Goodell's sign (softening of the vaginal portion of the cervix), Hegar's sign (softening of the uterus isthmus), and pigmentation of linea alba – Linea nigra, (darkening of the skin in a midline of the abdomen, caused by hyperpigmentation resulting from hormonal changes, usually appearing around the middle of pregnancy).[20][21]
Pregnancy detection can be accomplished using one or more various pregnancy[18] tests, which detect hormones generated by the newly formed placenta. Clinical blood and urine tests can detect pregnancy 12 days after implantation [22], which is as early as 6 to 8 days after fertilization. Blood pregnancy tests are more accurate than urine tests.[23] Home pregnancy tests are personal urine tests, which normally cannot detect a pregnancy until at least 12 to 15 days after fertilization. Both clinical and home tests can only detect the state of pregnancy, and cannot detect the date the embryo was conceived.
In the post-implantation phase, the blastocyst secretes a hormone named human chorionic gonadotropin, which in turn stimulates the corpus luteum in the woman's ovary to continue producing progesterone. This acts to maintain the lining of the uterus so that the embryo will continue to be nourished. The glands in the lining of the uterus will swell in response to the blastocyst, and capillaries will be stimulated to grow in that region. This allows the blastocyst to receive vital nutrients from the woman.
Despite all the signs, some women may not realize they are pregnant until they are quite far along in their pregnancy. In some cases, a few woman have not been aware of their pregnancy until they begin labour. This can be caused by many factors, including irregular periods (quite common in teenagers), certain medications (not related to conceiving children), and obese women who disregard their weight gain. Others may be in denial of their situation.
An early sonograph can determine the age of the pregnancy fairly accurately. In practice, doctors typically express the age of a pregnancy (i.e., an "age" for an embryo) in terms of "menstrual date" based on the first day of a woman's last menstrual period, as the woman reports it. Unless a woman's recent sexual activity has been limited, she has been charting her cycles, or the conception is the result of some types of fertility treatment (such as IUI or IVF), the exact date of fertilization is unknown. Without symptoms such as morning sickness, often the only visible sign of a pregnancy is an interruption of the woman's normal monthly menstruation cycle, (i.e., a "late period"). Hence, the "menstrual date" is simply a common educated estimate for the age of a fetus, which is an average of 2 weeks later than the first day of the woman's last menstrual period. The term "conception date" may sometimes be used when that date is more certain, though even medical professionals can be imprecise with their use of the two distinct terms. The due date can be calculated by using Naegele's rule. The expected date of delivery may also be calculated from sonogram measurement of the fetus. This method is slightly more accurate than methods based on LMP.[24] The beginning of labour, which is variously called confinement or childbed, begins on the day predicted by LMP 3.6% of the time and on the day predicted by sonography 4.3% of the time.[citation needed]
Diagnostic criteria are: Women who have menstrual cycles and are sexually active, a period delayed by a few days or weeks is suggestive of pregnancy; elevated B-hcG to around 100,000 mIU/mL by 10 weeks of gestation
Autistic kids grow normally despite limited diet
The study, which followed 79 UK children with autism spectrum disorders (ASDs) and nearly 13,000 autism-free children to the age of 7, found that although children with ASDs were more often rated as picky eaters by their parents, their average intake of calories and major nutrients was similar to their peers'.
Moreover, there were no differences in the two groups' weight and height attainment, researchers report in the journal Pediatrics.
"We think that these are reassuring findings, and that in general, parents of children with ASD symptoms need not worry that their children will not grow properly," Dr. Pauline Emmett, a senior research fellow at the University of Bristol in the UK, told Reuters Health in an email.
But, she noted, parents who are worried about their child's eating habits should bring it up with their doctor -- and can ask for a referral to a dietitian if they want more advice.
The term "autism spectrum disorders" refers to a group of developmental disorders that hinder people's ability to communicate and build relationships. The conditions range from severe cases of "classical" autism to Asperger's syndrome -- a disorder in which a person has normal intelligence and verbal skills, but difficulty socializing and understanding subtler forms of communication, like body language and vocal tone.
It's been known that children with ASDs often have unusual eating patterns or will only eat a limited selection of foods -- at least in part because of the general aversion to new experiences and the repetitive, ritualistic behaviors that mark the disorders.
But whether that tendency toward picky eating has consequences as far as growth and development has been unclear.
For the new study, Emmett and her colleagues used data from a long-term project that has followed the health of nearly 14,000 UK children since their birth in 1991 to 1992.
Of those children, 79 were diagnosed with an ASD at some point, including 30 with classical autism and 23 with Asperger's. The rest were diagnosed with "atypical" autism, which shares some of the features of classical autism but tends to be milder, or could not have their ASD classified.
Overall, children with ASDs had less varied diets than their peers, based on parents' responses to dietary questionnaires completed when their children were 6 months, 15 months and 2, 3 and 4 years old.
At the age of 4, for example, 37 percent of children with ASDs were deemed to be "very choosy" eaters, versus 14 percent of children without the disorders. Among those with ASDs, children with classical autism had more-limited diets than those with other ASD types.
However, the average intakes of calories, protein, fat and carbohydrates were all similar between children with ASDs and those without. And while children with the disorders tended to eat fewer vegetables and fruit than other children, they also drank less soda and ate fewer sweets.
There were also no differences between the two groups of children when it came to average height, weight and body mass index -- a measure of weight in relation to height -- or in blood levels of iron.
There were two differences in the children's diets overall: those with ASDs averaged less vitamin C -- probably, the researchers note, because they ate fewer fruits and vegetables -- and less vitamin D, which is obtained in the diet mainly from fortified milk products and fish.
Those vitamin gaps were not large, however, and were "unlikely to be important for the majority of the children," Emmett said.
Still, she added, the study looked at average differences between two groups of children; it's possible that some individual children with ASDs had deficiencies in vitamins C or
D.
The bottom line for parents, the researchers say, is that, despite their often-picky eating, children with ASDs seem to typically get enough major nutrients and grow normally.
Related info :
Early childhood follows the infancy stage, and begins with toddlerhood when the child begins speaking or taking steps independently. While toddlerhood ends around age three when the child becomes less dependent on parental assistance for basic needs, early childhood continues approximately through years seven or eight. According to the National Association for the Education of Young Children, early childhood spans the human life from birth to age eight.
Economic Status May Affect Kids’ Hearing Aid Care
Poor children with hearing loss are as likely as other children to receive cochlear implants, but they may experience more complications afterward, a U.S. study has found.
A cochlear implant is a small electronic device that helps provide a sense of sound to deaf people. Recent research suggests that only 55 percent of all U.S. children aged 1 to 6 who are candidates for cochlear implants receive them, according to the authors of the new study in the July issue of the Archives of Otolaryngology -- Head and Neck Surgery.
The researchers looked at 133 Ohio children who were referred for cochlear implants between 1996 and 2008, including 64 who were covered by Medicaid and 69 who were privately insured. There were no differences between the two groups in the likelihood of receiving an initial cochlear implant, age at referral to the implant program, or age at implantation.
But the investigators found that children in the Medicaid group were four times more likely to suffer complications than privately insured children (19.6 percent vs. 4.9 percent, respectively) and were also more likely to experience major complications (11.8 percent vs. 3.3 percent, respectively).
The Medicaid-covered children also missed many more follow-up appointments (35 percent vs. 23 percent) and more consecutive visits (1.9 percent vs. 1.1 percent) than those with private insurance, the report indicated.
"Given the excellent Medicaid coverage in Ohio, our results suggest that eliminating the definite financial obstacle that currently exists in other states across the nation for children from lower-income households would allow all eligible children, regardless of socioeconomic background, access to this powerful technology," study author David T. Chang, of Case Western Reserve University School of Medicine, University Hospitals Case Medical Center, Cleveland, and colleagues said in a news release form the journal's publisher.
"However, despite equal access among Medicaid-insured and privately insured patients, there seem to be important differences between the groups post-implantation that influence outcome, namely, decreased follow-up compliance, increased incidence of minor and major complications" and decreased rates of implantation of a second device in the other ear, they added.
"Taken together, these results indicate that centers should further investigate opportunities to minimize these downstream disparities," Chang's team concluded.
Related info :
Traditionally, doctors have measured pregnancy from a number of convenient points, including the day of last menstruation, ovulation, fertilization, implantation and chemical detection. In medicine, pregnancy is often defined as beginning when the developing embryo becomes implanted into the endometrial lining of a woman's uterus. In some cases where complications may have arisen, the fertilized egg might implant itself in the fallopian tubes or the cervix, causing an ectopic pregnancy. Most pregnant women do not have any specific signs or symptoms of implantation, although it is not uncommon to experience minimal bleeding at implantation. Some women will also experience cramping during their first trimester. This is usually of no concern unless there is spotting or bleeding as well. After implantation the uterine endometrium is called the decidua. The placenta, which is formed partly from the decidua and partly from outer layers of the embryo, is responsible for transport of nutrients and oxygen to, and removal of waste products from the fetus. The umbilical cord is the connecting cord from the embryo or fetus to the placenta. The developing embryo undergoes tremendous growth and changes during the process of fetal development.
Morning sickness occurs in about seventy percent of all pregnant women and typically improves after the first trimester.[25][dead link] Although described as "morning sickness", women can experience this nausea during afternoon, evening, and throughout the entire day.
In the first 12 weeks of pregnancy, the nipples and areolas darken due to a temporary increase in hormones.[26]
Most miscarriages occur during this period
IVF Linked to Greater Childhood Cancer Risk, Says Study
The first question many infertile couples ask when considering in vitro fertilization (IVF) is whether children born using the reproductive technology will be as healthy as those conceived the old-fashioned way. But the answer is a tricky one because there has been little definitive research to date on the potential long-term health risks of IVF.
The data is accumulating, however. Roughly 3.5 million children worldwide have been conceived by IVF over the past three decades, and many of them are now entering adulthood. With the growing population, researchers have begun pursuing larger studies on various aspects of development in IVF children - including the risks of conditions like autism, diabetes and cancer - and the results have hinted at some possible long-term health problems. (See pictures of a journey into the world of autism.)
The latest of these studies, published in the July issue of the medical journal Pediatrics, sought to evaluate the risk of cancer in childhood and early adulthood in IVF children. First, the bad news: the current study, the largest one of its kind so far, found a statistically significant increase in cancer risk in children conceived via IVF, compared with those who were traditionally conceived. Now the good news: the absolute risk of cancer in these children was still very low, and the authors think it may be due to other factors related to the parents' infertility, rather than the process of IVF itself.
The study of 2.4 million births, including 26,692 children born via IVF, between 1982 and 2005 found 56 cases of childhood and early adulthood cancers in IVF children, versus 38 cases that would be expected in other children of the same age-group. That's an increase in risk of 42%. While that figure sounds a little scary, lead author Dr. Bengt Kallen of the University of Lund in Sweden says the cancers his team studied, which included central-nervous-system tumors and a form of leukemia, are so rare to begin with that the excess risk translates to just one extra case of cancer per every 1,000 babies conceived by IVF. (Comment on this story.)
"There has been some uncertainty about this, and we just haven't had data good enough to show whether the risk is three or five times greater, as some people in the field believed. This paper shows us the risk in absolute terms is very small. That is the main message," says Kallen, adding that the findings persisted after controlling for age, weight and smoking status, among other characteristics, of the mother.
Why IVF babies may be at greater risk for cancer is not clear, but Kallen notes that these children are more likely than other babies to be born preterm and to suffer breathing problems that require oxygen therapy - factors that have been previously associated with an increased risk of cancer.
On the whole, IVF babies also tend to weigh less at birth than traditionally conceived babies - while low birth weight is not a risk factor for cancer, it is associated with other later health problems such as diabetes and obesity. Some researchers have also found epigenetic differences in the DNA of children conceived via IVF, compared with those conceived naturally, which may play a role in the long-term development of disease. (See how to prevent illness at any age.)
But the million-dollar question is whether any of the differences seen in IVF babies - from birth weight and preterm delivery to cancer risk - are the result of IVF treatment or the underlying infertility that caused mothers to pursue IVF in the first place. The new Swedish study cannot answer that question because it compared IVF children with those from the general population - that is, from families with no fertility problems.
According to Dr. William Gibbons, a professor at Baylor College of Medicine and the president of the American Society for Reproductive Medicine (ASRM), other studies conducted in Scandinavian countries have used different control groups and revealed interesting findings. Gibbons says that studies comparing IVF children with children of women who were infertile but conceived without IVF found no association between the fertility treatment and preterm birth, low birth weight or cancer risk. One Danish study published in 2007 in the journal Obstetrics and Gynecology reported no difference in babies' size for gestational age whether they were born to couples who used IVF to treat their infertility or those who did not. Another study from Norway, published in the Lancet in 2008, compared siblings conceived naturally and by IVF and also found no difference in babies' birth weight or size for gestational age. "There was no effect of IVF on these phenomena," says Gibbons.
University of North Carolina epidemiologist Andrew Olshan agrees that unknown factors relating to underlying infertility may well be contributing to many health conditions in children, but that it is very difficult to tease these factors out in a large enough study. Olshan says the Swedish study is a good one, but it is unlikely to be a game changer in the world of pediatric cancers. "We don't have a lot of leads as to what factors cause childhood cancers. IVF has been on the list of possible risk factors. It is still on the list, but I don't think this study moves it up the list. We'd need to see a collection of studies pointing in the same direction," he says.
Even if the study had confirmed IVF as a risk factor, experts say the level of increased risk is not enough to deter parents from undergoing the treatment. While IVF may bump up a tiny risk of childhood cancer, without it, many infertile couples may not have a baby at all.
Related info :
Childhood is the age span ranging from birth to adolescence.[1] In developmental psychology, childhood is divided up into the developmental stages of toddlerhood (learning to walk), early childhood (play age), middle childhood (school age), and adolescence (post-puberty).
