OB/GYN News Articles

Could hot flashes indicate risk of heart disease?

Study shows younger midlife women with hot flashes more likely to have poor vascular function

Hot flashes, one of the most common symptoms of menopause, have already been shown to interfere with a woman’s overall quality of life. A new study shows that, particularly for younger midlife women (age 40-53 years), frequent hot flashes may also signal emerging vascular dysfunction that can lead to heart disease. The study outcomes are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

The study involving 272 nonsmoking women aged 40 to 60 years is the first to test the relationship between physiologically assessed hot flashes and endothelial cell (the inner lining of the blood vessels) function. The effect of hot flashes on the ability of blood vessels to dilate was documented only in the younger fertile of women in the sample. There was no association observed in the older women (age 54-60 years), indicating that early occurring hot flashes may be those most relevant to heart disease risk. The associations were independent of other heart disease risk factors.

Cardiovascular disease is the leading cause of death in women. The results from the study, “Physiologically assessed hot flashes and endothelial function among midlife women,” may offer valuable information for healthcare providers working to assess the risk of heart disease in their menopausal patients. Hot flashes are reported by 70% of women, with approximately one-third of them describing them as frequent or severe. Newer data indicate that hot flashes often start earlier than previously thought — possibly during the late reproductive years — and persist for a decade or more. “Hot flashes are not just a nuisance. They have been linked to cardiovascular, bone, and brain health,” says Dr. JoAnn Pinkerton, executive director of NAMS. “In this study, physiologically measured hot flashes appear linked to cardiovascular changes occurring early during the menopause transition.”

 


 

Story Source:Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.

Journal Reference:

Rebecca C. Thurston, Yuefang Chang, Emma Barinas-Mitchell, J. Richard Jennings, Roland von Känel, Doug P. Landsittel, Karen A. Matthews. Physiologically assessed hot flashes and endothelial function among midlife women. Menopause, 2017; 1 DOI: 10.1097/GME.0000000000000857

 

Mother’s folic acid intake during pregnancy may decrease hypertension risk in children

Avocado – rich in folic acid.

A new article published in the American Journal of Hypertension finds that babies born to mothers with cardiometabolic risk factors were less likely to develop high blood pressure if their mothers had higher levels of folate during pregnancy.

Since the late 1980s, the prevalence of childhood elevated blood pressure has increased in the United States, in particular among African Americans. From a life course perspective, childhood high blood pressure can predict higher blood pressure values later in life, and people with higher blood pressure are at greater risk of developing cardiovascular, metabolic and kidney disease and stroke. Research has also shown that maternal cardiometabolic risk factors during pregnancy — including hypertensive disorders, diabetes, and obesity — are associated with higher offspring blood pressure.

Because controlling hypertension and cardiovascular disease in adults is difficult and expensive, identifying early-life factors for the prevention of high blood pressure may be an important and cost effective public health strategy.

There is growing evidence that maternal nutrition during pregnancy, through its impact on the fetal intrauterine environment, may influence offspring cardiometabolic health. Folate, which is involved in nucleic acid synthesis, gene expression, and cellular growth, is particularly important.

In young adults, higher folic acid intake has been associated with a lower incidence of hypertension later in life. Citrus juices and dark green vegetables are good sources of folic acid. However, the role of maternal folate levels, alone or in combination with maternal cardiometabolic risk factors on child blood pressure has not been examined in a prospective birth cohort.

In the current study, researchers analyzed the data from a prospective U.S. urban birth cohort, enriched by low-income racial and ethnic minorities at high risk for elevated BP, to examine whether maternal folic acid levels and cardiometabolic risk factors individually and jointly affect offspring blood pressure.

Researchers included 1290 mother-child pairs, 67.8% of which were Black and 19.2% of which were Hispanic, recruited at birth and followed prospectively up to age 9 years from 2003 to 2014 at the Boston Medical Center. Of the mothers, 38.2% had one or more cardiometabolic risk factors; 14.6% had hypertensive disorders, 11.1% had diabetes, and 25.1% had pre-pregnancy obesity. A total of 28.7% of children had elevated systolic blood pressure at age 3-9 years. Children with higher systolic blood pressure were more likely to have mothers with pre-pregnancy obesity, hypertensive disorders, and diabetes. Children with elevated systolic blood pressure were also more likely to have lower birth weight, lower gestational age, and higher BMI.

The study findings suggest that higher levels of maternal folic acid may help counteract the adverse associations of maternal cardiometabolic risk factors with child systolic blood pressure, although maternal folic acid levels alone were not associated with child systolic blood pressure. Among children born to mothers with any of the cardiometabolic risk factors, those whose mothers had folic acid levels above the median had 40% lower odds of elevated childhood systolic blood pressure. These associations did not differ appreciably in analyses restricted to African Americans, and they were not explained by gestational age, size at birth, child postnatal folate levels or breastfeeding.

“Our study adds further evidence on the early life origins of high blood pressure,” said Dr. Xiaobin Wang, the study’s senior corresponding author. “Our findings raise the possibility that early risk assessment and intervention before conception and during pregnancy may lead to new ways to prevent high blood pressure and its consequences across lifespan and generations.”


Story Source:

Materials provided by Oxford University Press USA. Note: Content may be edited for style and length.


Journal Reference:

  1. Hongjian Wang, Noel T. Mueller, Jianping Li, Ninglin Sun, Yong Huo, Fazheng Ren, Xiaobin Wang. Association of Maternal Plasma Folate and Cardiometabolic Risk Factors in Pregnancy with Elevated Blood Pressure of Offspring in Childhood. American Journal of Hypertension, 2017; DOI: 10.1093/ajh/hpx003

Cite This Page:

Oxford University Press USA. “High folic acid level in pregnancy may decrease high blood pressure in children.” ScienceDaily. ScienceDaily, 8 March 2017. <www.sciencedaily.com/releases/2017/03/170308081047.htm>.

Most Women of Child Bearing Age Lack Knowledge of Healthy Diet Says New Study

Dr. Lela Emad of the Women’s OB/GYN Medical Group discusses the latest findings on diet and nutrition among women and offers some guidelines for women planning for pregnancy.

A new study by the University of Pittsburgh Schools of the Health Sciences uncovers a national trend toward a less than optimal diet among women prior to pregnancy. “This information is particularly concerning for women who intend to conceive,” says Dr. Lela Emad of the Women’s OB/GYN Medical Group of Santa Rosa. “It’s imperative that prior to pregnancy, women follow a higher standard of nutrition for several reasons; to ensure healthy growth of the fetus, to reduce risks associated with premature birth, and to avoid the possibility of preeclampsia and maternal obesity – both of which carry added risks to the mother and baby.”

The study, published in the Journal of the Academy of Nutrition and Dietetics, assessed more than 7,500 women participants using the Healthy Eating Index-2010, measuring quality of diet including the intake for key food groups, while also measuring the consumption of less desirable aspects of a typical American diet such as refined grains, salt and calories from solid fats and sugars from food as well as from alcohol consumption.

Ultimately, more than a third of the calories the women in the study consumed came from ‘empty calories’ from such things as;

  • sugar-sweetened beverages,
  • pasta dishes
  • grain desserts
  • Soda
  • beer, wine and spirits

“This list consists of just about everything we would recommend a woman who was in a preconception phase to avoid,” Dr. Emad points out. “A healthy diet goes a long way toward ensuring a healthy pregnancy, and planning ahead for pregnancy by participating in a Preconception Healthcare Plan is one of the best things a woman can do both for her baby and for herself.”

What is Preconception Healthcare

Preconception healthcare describes medical care provided to a woman that is designed to increase the chances of having a positive pregnancy experience and a healthy baby. Preconception healthcare is uniquely designed for every individual, customized for personal needs and circumstances. It typically offers an introduction to guidelines for a healthy diet as part of the overall education and planning process.

“We encourage parents – that is, both parents – to begin making healthy lifestyle changes up to one full year prior to trying to get pregnant,” explains Dr. Emad. “This process improves a woman’s chances of becoming pregnant and prepares her body so it can provide the best environment for her infant.” During a preconception care visit, the OB/GYN healthcare provider will focus on lifestyle, medical and family history, previous pregnancies and currently prescribed medications. In addition to diet and exercise, topics may include alcohol, tobacco, and caffeine use; recreational drug use, birth control, family histories, genetics as well as health issues and other concerns (diabetes, high blood pressure, depression, obesity, etc.)

Healthy Diet and Supplements

“We also encourage our patients and their families to adopt a nutrient rich and calorie conscious diet prior to and during pregnancy. This is the best way to prevent excessive weight gain and cut the potential risk of obstetric complications,” says Dr. Emad. “Planning ahead and taking steps to ensure optimal pre-pregnancy health is a great way to create a healthy family.”

Learning how to make smart food choices as well as being mindful about food preparation is important, as is knowing which foods to avoid or limit during pregnancy. Foods that contain sources of folic acid (vitamin B9) are important nutritional elements to incorporate into both the preconception and pregnancy diet. Folic acid helps to prevent some birth defects – particularly those affecting the brain and spinal cord. Folic acid is best taken before pregnancy and in the very early stages of pregnancy.

Although the bulk of nutrients should ideally come from eating fresh healthy foods, it is generally recommended that women start taking a prenatal vitamin supplement before pregnancy. Prenatal vitamin supplements are specifically formulated to contain all the recommended daily vitamins and minerals needed before and during pregnancy.

About Women’s OBGYN Medical Group

The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. To learn more about these fine physicians and the many services provided by the Women’s OB/GYN Medical Group visit the website. Call for an appointment at (707) 579-1102.

Good news for mature women: weight loss is possible after menopause

Talk to a woman in menopause and you’re likely to hear complaints about hot flashes and an inability to lose weight, especially belly fat. A new study shows how regular exercise can help reduce weight and control bothersome symptoms such as hot flashes, even in women who previously led sedentary lifestyles. The study outcomes are being published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Decreased estrogen levels during the menopause transition often create an array of physical and mental health issues that detract from a woman’s overall quality of life. The article “Improvements in health-related qualify of life, cardio-metabolic health, and fitness in postmenopausal women after a supervised, multicomponent, adapted exercise program in a suited health promotion intervention: a multigroup study” reports on 234 Spanish postmenopausal women aged 45 to 64 years who had at least 12 months of sedentary behavior and engaged in a supervised 20-week exercise program for the study. After the intervention, the participants experienced positive changes in short- and long-term physical and mental health, including significant improvements in their cardiovascular fitness and flexibility. In addition, they achieved modest but significant reductions in their weight and body mass index, and their hot flashes were effectively managed. This is especially good news for women who are reluctant to use hormones to manage their menopause symptoms and are looking for safe but effective nonpharmacologic options without adverse effects.

“Growing evidence indicates that an active lifestyle with regular exercise enhances health, quality of life, and fitness in postmenopausal women,” says Dr. JoAnn Pinkerton, NAMS executive director. “Documented results have shown fewer hot flashes and improved mood and that, overall, women are feeling better while their health risks decrease.


Story Source:Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.


Read this article on ScienceDaily:

The North American Menopause Society (NAMS). “Weight loss actually possible after menopause.” ScienceDaily. ScienceDaily, 15 February 2017. <www.sciencedaily.com/releases/2017/02/170215084052.htm>.

Can eating soy products affect breast health?

Georgetown Lombardi Comprehensive Cancer Center researchers have used animal models to reveal new information about the impact — positive and negative — that soy consumption could have on a common breast cancer treatment.

The scientists have uncovered the biological pathways in rats by which longtime soy consumption improves effectiveness of tamoxifen and reduces breast cancer recurrence. But they also show why eating or drinking soy-based foods for the first time while being treated with tamoxifen can, conversely, reduce effectiveness of the drug, and promote recurrence.

The study, published in Clinical Cancer Research, uncovers the molecular biology behind how soy consumption, especially its most active isoflavone, genistein, affects tamoxifen — both positively and negatively.

It also mirrors what has been observed in breast cancer patients, says the study’s senior investigator Leena Hilakivi-Clarke, PhD, professor of oncology at Georgetown Lombardi.

“There has long been a paradox concerning genistein, which has the similar structure as estrogen and activates both human estrogen receptors to a degree. Estrogen drives most breast cancer growth, yet high soy intake among women in Asian countries has been linked to a breast cancer rate that is five times lower than Western women, who eat much less soy,” she says. “So why is soy, which mimics estrogen, protective in Asian women?”

More than 70 percent of the 1.67 million women diagnosed with breast cancer worldwide in 2012 was estrogen-receptor positive, and tamoxifen and other endocrine therapies meant to reduce the ability of estrogen to promote cancer growth, are the most common drugs used for these cancers. Although endocrine therapies can be highly effective in preventing or treating breast cancer, about half of patients who use them exhibit resistance and/or have cancer recurrence.

Employing a more advanced rat model of breast cancer and tamoxifen use than has been used in past studies, the researchers found that the timing of genistein intake is the central issue.

Longtime sustained use of genistein before development of breast cancer improves overall immunity against cancer, thus protecting against cancer development and recurrence, says the study’s lead researcher, Xiyuan Zhang, PhD.

“It also inhibits a mechanism called autophagy that would allow cancer cells to survive, which explains why it helps tamoxifen work,” says Zhang, a member of Hilakivi-Clarke’s laboratory when this study was conducted. She is currently a postdoctoral researcher at the National Institutes of Health.

Previous studies in women show no evidence of adverse effects of soy intake on breast cancer outcome, the researchers say, adding that research has also shown that Asian and Caucasian women who consumed as little as 1/3rd cup of soymilk daily (10 mg. of isoflavones) had the lowest risk of breast cancer recurrence.

The animal studies suggest it is a different story when soy consumption begins after breast cancer develops.

Starting consuming genistein in a diet after breast cancer develops in the animals did not trigger anti-tumor immune response to eliminate cancer cells, Zhang says. “We do not know yet why this made the animals resistant to the beneficial effects of tamoxifen and increased risk of cancer recurrence,” she continued.

Animals consuming genistein as adults on had a 7 percent chance of breast cancer recurrence after tamoxifen treatment, compared with a 33 percent recurrence with rats exposed to genistein only after breast cancer developed.

“We have solved the puzzle of genistein and breast cancer in our rat model, which perfectly explains the paradox seen in earlier animal studies and patients,” says Hilakivi-Clarke. “While many oncologists advise their patients not to take isoflavone supplements or consume soy foods, our findings suggest a more nuanced message — if these results hold true for women. Our results suggest that breast cancer patients should continue consuming soy foods after diagnosis, but not to start them if they have not consumed genistein previously.”


Story Source:

Materials provided by Georgetown University Medical Center. Note: Content may be edited for style and length.


Read this article on ScienceDaily: Georgetown University Medical Center. “Understanding when eating soy might help or harm in breast cancer treatment.” ScienceDaily. ScienceDaily, 1 February 2017. www.sciencedaily.com/releases/2017/02/170201092711.htm.

Women’s OB/GYN Medical Group of Santa Rosa Focuses on Cervical Health Awareness Month

Dr. Lela Emad offers hope for women concerned about cervical cancer risks, and shares important tips for staying healthy.

Healthy Women January is Cervical Health Awareness Month and there’s good news for the 13,000 women in the United States who are expected to be diagnosed with cervical cancer this year; early detection increases the 5-year survival rate for women with invasive cervical cancer (the worse-case scenario) by up to a whopping 92 percent. “To catch it early, a woman must get screened annually,” explains Dr. Lela Emad OB/GYN, “This is an important factor for the four out of five women who do not receive routine check-ups that includes a Pap Test.”

What is cervical cancer

At one time, cervical cancer was the most prominent cause of cancer death for American women. But, thanks to early detection and new treatment options developed over the last 40 years, the cervical cancer death rate has been cut in half. The real hero in this story is a simple test most women are very familiar with; the Pap test. This screening procedure makes it possible for healthcare professionals to catch minute changes in the cervix well before it has a chance to develop into cancer. Pap tests can also find cervical cancer early – when it is in its most curable stage – giving women with a positive diagnosis an even better chance of beating the disease.

The latest statistics from the American Cancer Society estimates that in the United States;

  • About 12,820 new cases of invasive cervical cancer will be diagnosed
  • About 4,210 women will die from cervical cancer

What causes cervical cancer?

The vast majority of both women and men will become infected with the Human papillomavirus or HPV at some point during their lifetimes and HPV is found in about 99 percent of cervical cancers cases. Although most HPV infections are benign and disappear on their own, some persist. Of the more than 100 different types of HPV most are considered low-risk and do not lead to cervical cancer. But some high-risk HPV strains persist to cause cervical cell abnormalities and go on to develop into cancer. The two types of the virus HPV-16 and HPV-18 are consider the most high-risk HPV strains.

Who gets cervical cancer

Most cases of cervical cancer are found in women between the ages of 20 and 50, and even women who have entered into menopause may still be at risk. About 20 percent of all cervical cancers are found in women over the age of 65. Cervical cancer rarely occurs in women who have received routine screenings for the disease during the years before they turned 65. In the United States, Hispanic women are most likely to get cervical cancer, followed by African-Americans, American Indians and Alaskan natives, and whites. Asians and Pacific Islanders have the lowest risk of cervical cancer in this country.

What is cervical cancer?

Cancer initiates in the body when otherwise normal cells begin to grow out of control, and it can affect any part of the body and even spread to other areas of the body. Cervical cancer begins in the cells lining the cervix — the lower part of the uterus (womb). Although cervical cancers start from cells in the pre-cancerous stages, only some of the women with pre-cancers of the cervix will go on to actually develop cancer. It normally takes a number of years before cervical pre-cancer turns into full blown cervical cancer, but it can happen in less time in some women. For most women, pre-cancerous cells resolve on their own without any treatment. But, treating all cervical pre-cancers can prevent almost all cervical cancers.

Symptoms of cervical cancer

Symptoms of the more advanced disease have been known to include abnormal or irregular vaginal bleeding, pain during sex, and/or unusual vaginal discharge. Abnormal bleeding symptoms outside of regular menstrual periods, after sexual intercourse or douching and bleeding after a pelvic exam can be symptoms of cervical cancer as can bleeding after menopause. Other symptoms include pelvic pain not related to the menstrual cycle, heavy or unusual discharge, increased urinary frequency and pain during urination. Of course, these symptoms could also be signs of other health problems not related to cervical cancer, but the best way to find out is to talk to a healthcare provider.

Prevention

Precancerous cervical cell changes and early cancers of the cervix generally do not cause any unusual symptoms. For this reason, routine screening through Pap and HPV tests is the best way to catch precancerous cell changes early, thereby preventing the development of cervical cancer.

“Pap test screening is obviously the first line of defense against cervical cancer,” says Dr. Emad. “We recommend Pap tests for women on a semi-annual basis after turning 21.” Regular gynecological Pap tests are the best way to detect most abnormal cell changes due to HPV well before they become cancer.

“Early detection of precancer cells makes it possible for a woman to be effectively treated before it becomes malignant, but unfortunately not every woman in committed to receive a regular Pap Test. This needs to become a priority for every woman, and particularly those who are intent on staying healthy.”

About Women’s OB/GYN Medical Group

Women’s OB/GYN Medical Group offers comprehensive testing with the latest available technology to screen for a full-spectrum of diseases and symptoms, and to monitor conditions as they develop in order to maximize patients’ health and well-being. The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Visit the website to learn more or call 707-579-1102 to schedule an appointment.

Dr. Susan Logan Recognized as Among the “Top Doctors” in the Bay Area by San Francisco Magazine

Susan Logan, M.D. of NCMA Women’s OB/GYN Medical Group has been selected by the San Francisco Magazine as among the top Obstetrics and Gynecology doctors for 2017.

San Francisco Magazine recently queried area doctors to nominate their choice of best physicians in eight Bay Area counties for 2017. Almost 1,000 nominations were submitted and a little over 500 physicians were selected by the healthcare research company managing the award process. Results were announced the magazine’s January 2017 issue.

Under the category of Obstetrics and Gynecology, Women’s OB/GYN Medical Groups physician Dr. Susan Logan has been selected for this honor by San Francisco Magazine for two years consecutively.

Dr. Lela Emad of the Women’s OB/GYN Medical Group says, “Dr. Susan C. Logan is a respected, caring OB/GYN certified by the American Board of Obstetrics and Gynecology. She has been a part of our group since the early 90s, and has played an integral role in building the practice. We are honored to have her among our providers and her patients are lucky to have someone so knowledgeable to deliver such quality caring support for their healthcare needs.”

Dr. Logan also serves as Antepartum Testing Medical Director at Santa Rosa Memorial Hospital, as well as the Medical Director of the Sweet Success Program.

About the Women’s OB/GYN Medical Group

With a team made up of compassionate, expert doctors, midwives, nurses and medical assistants aimed at providing unmatched care to patients, the Women’s OB/GYN Medical Group offers a full range of obstetrics and gynecology services to women in the North Bay region.  Services offered include;

  • general gynecological health screenings
  • state-of-the-art diagnostics
  • comprehensive pregnancy and postpartum care
  • full mid-wifery services
  • minimally invasive laparoscopic surgery
  • uro-gynecological procedures
  • incontinence care
  • menopause care
  • laser hair reduction, skin care and Botox Cosmetic

Women’s OB/GYN Medical Group’s staff of physicians include; Lela Emad, MD, Shazah Khawaja, MD, Amita Kachru, MD, and Susan Logan, MD. Together, these doctors share a unique whole-body approach to medicine as they strive to find the underlying causes of a woman’s health problems, rather than simply treating the symptoms.

The team of health professionals at Women’s OB/GYN is committed to both alleviating short-term ailments and maximizing long-term health. The practice partnered with Northern California Medical Associates (NCMA) in 2014 to strengthen its network of experienced healthcare providers, directly benefitting patient access to healthcare specialists in the area.

The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. To learn more about these fine physicians and the many services provided by the Women’s OB/GYN Medical Group visit the website. Call for an appointment at (707) 579-1102.

Who has better memory recall: men or women?

woman-thinkingIn the battle of the sexes, women have long claimed that they can remember things better and longer than men can. A new study proves that middle-aged women outperform age-matched men on all memory measures, although memory does decline as women enter postmenopause. The study is being published online in Menopause, the journal of The North American Menopause Society (NAMS).

Memory loss, unfortunately, is a well-documented consequence of the aging process. Epidemiological estimates suggest that approximately 75% of older adults report memory-related problems. Women report increased forgetfulness and “brain fog” during the menopause transition. In addition, women are disproportionately at risk for memory impairment and dementia compared with men. Despite these conditions working against them, middle-aged women still outscore their similarly aged male counterparts on all memory measures, according to the study.

The cross-sectional study of 212 men and women aged 45 to 55 years assessed episodic memory, executive function, semantic processing, and estimated verbal intelligence through cognitive testing. Associative memory and episodic verbal memory were assessed using a Face-Name Associative Memory Exam and Selective Reminding Test.

In addition to comparing sex differences, the study also found that premenopausal and perimenopausal women outperformed postmenopausal women in a number of key memory areas. Declines in estradiol levels in postmenopausal women were specifically associated with lower rates of initial learning and retrieval of previously recalled information, while memory storage and consolidation were maintained.

“Brain fog and complaints of memory issues should be taken seriously,” says Dr. JoAnn Pinkerton, NAMS executive director. “This study and others have shown that these complaints are associated with memory deficits.”


Story Source:

Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.


Journal Reference:

  1. Dorene M. Rentz, Blair K. Weiss, Emily G. Jacobs, Sara Cherkerzian, Anne Klibanski, Anne Remington, Harlyn Aizley, Jill M. Goldstein. Sex differences in episodic memory in early midlife. Menopause, 2016; 1 DOI: 10.1097/GME.0000000000000771

The North American Menopause Society (NAMS). “Who has the better memory, men or women?.” ScienceDaily. ScienceDaily, 9 November 2016. www.sciencedaily.com/releases/2016/11/161109112447.htm.

The Women’s OB/GYN Medical Group of Santa Rosa focuses on Gestational Diabetes for National Diabetes Month

Dr. Lela Emad shares insight into gestational diabetes and what pregnant women need to consider when it comes to diabetes to ensure a healthy pregnancy.

November is National Diabetes Month and is observed every year to bring attention to diabetes and its impact on millions of Americans. As part of this year’s theme Managing Diabetes – It’s Not Easy, But It’s Worth It the Women’s OB/GYN Medical Group is focusing on Gestational diabetes, a form of glucose intolerance that is diagnosed during pregnancy.

Nationally, about seven to 14 percent of all pregnant women develop gestational diabetes. And, according to the California Diabetes and Pregnancy Program, ethnic groups such as African American, Asian American, East Indian, Latina/Hispanic and Native American are more vulnerable to developing gestational diabetes, as are women who are overweight or have type 2 diabetes in the family.

“Diabetic women have more risk for complications both during and after pregnancy,” explains Dr. Emad. “It is important for pregnant women who know they have diabetes to manage symptoms, and for all women either pregnant or considering pregnancy to get checked for diabetes to avoid any potential complications.”

Gestational diabetes also increases the risk that the mother and the baby may develop type 2 diabetes later in life. Additional complications to pregnant women due to diabetes can include:

  • high blood pressure
  • eye disease
  • kidney disease
  • too much weight gain
  • severe hypoglycemia (low blood sugar)
  • diabetic ketoacidosis (DKA)

Babies can also be at risk for complications including; high birth weight, birth defects, delivery complications and jaundice. Diabetes can lead to higher rates of miscarriage and stillbirth, so it is very important to manage symptoms early in the pregnancy under the care of a healthcare provider. Ongoing treatment is necessary to bring maternal blood glucose to normal levels and to help avoid any potential complications for the baby.

Managing Diabetes

Following a well-balanced, healthy diet is an important component to a healthy pregnancy and for women with diabetes, diet plays an especially important role. Not eating properly can cause glucose levels to fluctuate from too high or too low, which can result in some fairly serious symptoms. Glucose levels can be controlled with a combination of eating right, exercising and taking medications as directed by a health care provider. Check-ups may also need to be scheduled more frequently.

Hypoglycemia

Pregnant women with a history of diabetes, or who have developed gestational diabetes, are more likely to experience low blood glucose levels (hypoglycemia) and it usually occurs when skipping a meal, or when altering eating routines. Hypoglycemia can also manifest following vigorous exercise. Typical symptoms include; dizziness, sudden hunger, sweating, feeling shaky or general weakness.

 Exercise

Adopting and maintaining an exercise routine will help to support normal glucose levels. Exercise also helps to control weight; improves energy levels, aids sleep, and reduces symptoms including; backaches, constipation and bloating.

Medications During Pregnancy

Insulin dosages for women with pre-existing diabetes will usually increase during pregnant. Insulin is considered safe to use during pregnancy and does not cause birth defects.

Diabetes, Labor and Delivery

If problems with the pregnancy arise, labor may be induced prior to the due date. During labor, glucose levels are closely monitored. Occasionally insulin through an intravenous (IV) line may be required during labor.

Diabetes and Breastfeeding

Whether or not diabetes is a factor, experts highly recommend breastfeeding as it provides the baby the best means of nutrition and it is good for the mother as well. Breastfeeding can help reduce extra weight gained during pregnancy. It is also hailed by researchers for helping to reduce the risk of developing breast cancer.

“Working with a specialist to manage blood sugar before and during pregnancy can be a life saver,” says Dr. Emad. “It an important measure to take to decrease the risk of complications, and to provide the best outcomes for both mother and baby.”

About the Women’s OB/GYN Medical Group

When thinking about having a baby, The Women’s OB/GYN Medical Group of providers encourages women to begin making healthy lifestyle changes one full year prior to trying to get pregnant. This process improves the chances of becoming pregnant soon after beginning to try, and prepares a woman’s body to provide the best environment for her infant.

For women who may be considering having a baby it’s important to schedule an appointment with a physician or certified nurse midwife to receive expert guidance from the start. The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Visit our website to learn more or call 707-579-1102 to schedule an appointment.

Hot in the news: Calcium supplements may damage the heart

A capsule with calcium supplement pills

Read this article on ScienceDaily

A study conducted by Johns Hopkins Medicine concluded that taking calcium in the form of supplements may raise the risk of plaque buildup in arteries and heart damage, although a diet high in calcium-rich foods appears be protective, say researchers at conclusion of their study that analyzed 10 years of medical tests on more than 2,700 people.

After analyzing 10 years of medical tests on more than 2,700 people in a federally funded heart disease study, researchers at Johns Hopkins Medicine and elsewhere conclude that taking calcium in the form of supplements may raise the risk of plaque buildup in arteries and heart damage, although a diet high in calcium-rich foods appears be protective.

In a report on the research, published Oct. 10 in the Journal of the American Heart Association, the researchers caution that their work only documents an association between calcium supplements and atherosclerosis, and does not prove cause and effect.

But they say the results add to growing scientific concerns about the potential harms of supplements, and they urge a consultation with a knowledgeable physician before using calcium supplements. An estimated 43 percent of American adult men and women take a supplement that includes calcium, according the National Institutes of Health.

“When it comes to using vitamin and mineral supplements, particularly calcium supplements being taken for bone health, many Americans think that more is always better,” says Erin Michos, M.D., M.H.S., associate director of preventive cardiology and associate professor of medicine at the Ciccarone Center for the Prevention of Heart Disease at the Johns Hopkins University School of Medicine. “But our study adds to the body of evidence that excess calcium in the form of supplements may harm the heart and vascular system.”

The researchers were motivated to look at the effects of calcium on the heart and vascular system because studies already showed that “ingested calcium supplements — particularly in older people — don’t make it to the skeleton or get completely excreted in the urine, so they must be accumulating in the body’s soft tissues,” says nutritionist John Anderson, Ph.D., professor emeritus of nutrition at the University of North Carolina at Chapel Hill’s Gillings School of Global Public Health and a co-author of the report. Scientists also knew that as a person ages, calcium-based plaque builds up in the body’s main blood vessel, the aorta and other arteries, impeding blood flow and increasing the risk of heart attack.

The investigators looked at detailed information from the Multi-Ethnic Study of Atherosclerosis, a long-running research project funded by the National Heart, Lung, and Blood Institute, which included more than 6,000 people seen at six research universities, including Johns Hopkins. Their study focused on 2,742 of these participants who completed dietary questionnaires and two CT scans spanning 10 years apart.

The participants chosen for this study ranged in age from 45 to 84, and 51 percent were female. Forty-one percent were white, 26 percent were African-American, 22 percent were Hispanic and 12 percent were Chinese. At the study’s onset in 2000, all participants answered a 120-part questionnaire about their dietary habits to determine how much calcium they took in by eating dairy products; leafy greens; calcium-enriched foods, like cereals; and other calcium-rich foods. Separately, the researchers inventoried what drugs and supplements each participant took on a daily basis. The investigators used cardiac CT scans to measure participants’ coronary artery calcium scores, a measure of calcification in the heart’s arteries and a marker of heart disease risk when the score is above zero. Initially, 1,175 participants showed plaque in their heart arteries. The coronary artery calcium tests were repeated 10 years later to assess newly developing or worsening coronary heart disease.

For the analysis, the researchers first split the participants into five groups based on their total calcium intake, including both calcium supplements and dietary calcium. After adjusting the data for age, sex, race, exercise, smoking, income, education, weight, smoking, drinking, blood pressure, blood sugar and family medical history, the researchers separated out 20 percent of participants with the highest total calcium intake, which was greater than 1,400 milligrams of calcium a day. That group was found to be on average 27 percent less likely than the 20 percent of participants with the lowest calcium intake — less than 400 milligrams of daily calcium — to develop heart disease, as indicated by their coronary artery calcium test.

Next, the investigators focused on the differences among those taking in only dietary calcium and those using calcium supplements. Forty-six percent of their study population used calcium supplements.

The researchers again accounted for the same demographic and lifestyle factors that could influence heart disease risk, as in the previous analysis, and found that supplement users showed a 22 percent increased likelihood of having their coronary artery calcium scores rise higher than zero over the decade, indicating development of heart disease.

“There is clearly something different in how the body uses and responds to supplements versus intake through diet that makes it riskier,” says Anderson. “It could be that supplements contain calcium salts, or it could be from taking a large dose all at once that the body is unable to process.”

Among participants with highest dietary intake of calcium — over 1,022 milligrams per day — there was no increase in relative risk of developing heart disease over the 10-year study period.

“Based on this evidence, we can tell our patients that there doesn’t seem to be any harm in eating a heart-healthy diet that includes calcium-rich foods, and it may even be beneficial for the heart,” says Michos. “But patients should really discuss any plan to take calcium supplements with their doctor to sort out a proper dosage or whether they even need them.”

According to the U.S. Centers for Disease Control and Prevention, coronary heart disease kills over 370,000 people each year in the U.S. More than half of women over 60 take calcium supplements — many without the oversight of a physician — because they believe it will reduce their risk of osteoporosis.


Story Source:

Materials provided by Johns Hopkins Medicine. Note: Content may be edited for style and length.


Journal Reference:

  1. John J.B. Anderson, Bridget Kruszka, Joseph A.C. Delaney, Ka He, Gregory L. Burke, Alvaro Alonso, Diane E. Bild, Matthew Budoff, Erin D. Michos. Calcium Intake From Diet and Supplements and the Risk of Coronary Artery Calcification and its Progression Among Older Adults: 10‐Year Follow‐up of the Multi‐Ethnic Study of Atherosclerosis (MESA). Journal of the American Heart Association, 2016; 5 (10): e003815 DOI: 10.1161/JAHA.116.003815

Johns Hopkins Medicine. “Calcium supplements may damage the heart.” ScienceDaily. ScienceDaily, 11 October 2016. www.sciencedaily.com/releases/2016/10/161011182621.htm.