Women's Health: Window into women's sexuality ♦ Weight gain between pregnancies linked to increased risk of stillbirth ♦ Live together or get married?

Window into women's sexuality Heterosexual women have more diverse patterns of sexual response than previously reported, new research shows. Among women, say the authors, there is significant diversity among women in their sexual attractions to other women and men, regardless of sexual identity.

Incarcerated mothers impact children's future criminal involvement Children of incarcerated mothers are twice as likely to be arrested, convicted and incarcerated as adults. The survey, conducted in four waves, includes data on social, economic, psychological, and physical well-being, as well as information on the family, neighborhood, community, school, friendships, peer groups, and romantic relationships, to see how behavior and environment are linked to health and achievement outcomes.

Live together or get married? Study finds similar emotional benefits When it comes to emotional health, young couples -- especially women -- do just as well moving in together as they do getting married.

Weight gain between pregnancies linked to increased risk of stillbirth and infant death Mothers of healthy weight during their first pregnancy who gain even a moderate amount of weight (around 6 kg in a woman of average height) between their first and second pregnancies increase the risk of their baby dying in its first year of life.

US stillbirth rates unchanged after move to discourage elective deliveries before 39 weeks

The recommendation to delay delivery of otherwise healthy infants until at least the 39th week of pregnancy does not appear to have increased stillbirths in the United States, according to a study by researchers at the National Institutes of Health and other institutions. These findings contradict an earlier study that raised the concern that waiting until 39 weeks could lead to more stillbirths.

Research has shown that foregoing delivery before 39 weeks, either by induced labor or via cesarean, when there is no medical reason to deliver early lowers the chances of newborn illness and death. Yet one study linked a policy in a large hospital group of avoiding such optional, or elective, deliveries before 39 weeks to an increase in stillbirths in its patients.

Now, after analyzing national infant birth and death statistics over several years, NIH researchers have concluded that efforts to prevent elective deliveries are not linked to an increase in stillbirth on a national level.

“The bottom line is that waiting until the 39th week to deliver a baby—provided there is no medical need to deliver before then—is still a good idea,” said the study’s second author, Uma Reddy, M.D., a researcher with NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “When examining the statistics on a national scale, we did not see a commensurate increase in stillbirths nationally after the recommendation went into effect.”

The study was published in Obstetrics & Gynecology. The first author is Marian F. MacDorman, Ph.D., at the University of Maryland, College Park, and the senior author is Robert M. Silver, M.D., University of Utah Health Sciences Center in Salt Lake City.

In 2011, NICHD held a workshop on the timing of births. After reviewing the research, workshop attendees recommended that physicians avoid elective (non-medical) deliveries before the 39th week of pregnancy. When compared to infants born after 39 weeks, those born in the 37th and 38th weeks were at a higher risk for respiratory problems, low blood sugar and newborn sepsis (a blood infection). They also were more likely to spend time in a newborn intensive care unit.

However, after instituting a policy to avoid elective deliveries among its patients, a large regional medical center in the Northeastern United States reported an increase in stillbirths after reviewing the records of more than 24,000 births.

For the current study, the researchers analyzed national data from the U.S. fetal death and live birth data files(link is external) of the Centers for Disease Control and Prevention. The authors compared stillbirth rates and trends from 2006, before the recommendation to avoid elective deliveries, to those occurring in 2012, the most recent year after the recommendation that data were available. The researchers chose 2006 because the rate of preterm births began falling in that year. In theory, a decrease in the number of preterm births might affect the rate of stillbirths, as fetuses who were not delivered preterm could result in a stillbirth later in pregnancy. The analysis encompassed totals of roughly 50,000 stillbirths and 8.2 million live births, combined, for the two years they studied.

The researchers used two methods to calculate the rate of stillbirths: traditional and prospective. The traditional method of calculating stillbirths involves comparing the number of stillbirths to the total number of deliveries at a given gestational age. For 2006 and 2012, the rate of stillbirths was the same: 6.05 stillbirths per 1000 deliveries. In 2012, stillbirth rates increased by 15 to16 percent at 34-36, 37 and 38 weeks  because of a drop in the total number of births at these gestational ages. Because the number of births at each week before 39 weeks dropped, there were proportionally more stillbirths per deliveries. At 39 weeks gestation, the traditional stillbirth rate dropped slightly for 2012, although the drop was not statistically significant.

The prospective method of calculating stillbirth compares the total number of stillbirths for a given week of gestation to the total number of women pregnant at that gestational week, plus those pregnant at all gestational weeks after that. This method is a more accurate way to estimate stillbirth risk, the study authors wrote, because it compares the proportion of stillbirths among pregnant women. Between 2006 and 2012, the researchers saw no differences in the prospective stillbirth rates at 34-36, 37 and 38 weeks gestation.

“The lack of change in the prospective stillbirth rates indicates that preventing elective deliveries before 39 weeks did not increase the national stillbirth rate,” said Dr. MacDorman.

The study authors noted that, in recent years, there have been declines in preterm births, infant deaths and perinatal deaths. Perinatal mortality data includes stillbirths at 20 weeks or greater and any newborn death before 28 days. However, stillbirth rates have remained unchanged. They added that, to decrease the stillbirth rate, more research is needed to identify women at risk for stillbirth early in pregnancy and to develop more effective means to monitor these pregnancies, as well as how to prevent stillbirths from occurring.

NICHD’s National Child and Maternal Health Education Program has videos explaining the benefits of carrying a pregnancy to at least 39 weeks unless there is a medical reason to deliver.

Health News: 56 Salmonella cases appear to be linked to pork in Washington State ♦ New Drug Resistant Bacteria, Klebsiella ♦ Stillbirth outnumber infant death in US for first time

Stillbirth outnumber infant death in US for first time The number of stillbirths in the United States was higher, for the first time, than the number of babies who died before their first birthday, according to a new study on infant mortality by the Centers for Disease Control and Prevention.

New Drug Resistant Bacteria, Klebsiella, Found in Chicken, turkey, and Pork Chicken, turkey and pork sold in grocery stores harbors disease-causing bacteria known as Klebsiella pneumoniae, according to a new study. The research, which was published online today in the journal Clinical Infectious Diseases, shows that contaminated meat may be an important source of human exposure to Klebsiella. The U.S. food safety system has traditionally focused on a few …

56 Salmonella cases appear to be linked to pork in Washington State; Washington state health officials are working with state and local partners to investigate several cases and clusters of Salmonella infections that appear to be linked to eating pork. The ongoing investigation of at least 56 cases in eight counties around the state includes food served at a variety of events. Disease investigators continue to explore...

Gene mutation contributes to liver disease in patients of normal weight Non-alcoholic fatty liver disease (NAFLD) is a major worldwide health problem. The disease is strongly associated with obesity and has been found in a high percentage Asian patients of normal weight. The PNPLA3 mutant genotype has been consistently shown to be a major factor in the development of NAFLD, but the effect of a patient's weight on the relationship between NAFLD and the mutant gene had not been determined until now, at the conclusion of a study on the issue

DNA damage seen in patients undergoing CT scanning, study finds Using new laboratory technology, scientists have shown that cellular damage is detectable in patients after CT scanning. In this study, researchers examined the effects on human cells of low-dose radiation from a wide range of cardiac and vascular CT scans. These imaging procedures are commonly used for a number of reasons, including management of patients suspected of having obstructive coronary artery disease, and for those with aortic stenosis, in preparation of transcatheter aortic valve replacement

Woman's Health: In ERs, UTIs and STIs in women misdiagnosed ♦ India's abortion law puts women at risk ♦ Women in developed world still face many barriers to early abortion

In ERs, UTIs and STIs in women misdiagnosed, even mixed up nearly half the time Urinary tract and sexually transmitted infections in women are misdiagnosed by emergency departments nearly half the time, according to research. These misdiagnoses result in overuse of antibiotics, and increased antibiotic resistance.

Women's sport participation and gender equality: African women in the beautiful game Despite a notably high percentage of women in political positions, South Africa has high rates of rape and domestic violence, suggesting poor gender equality, widespread discrimination and male dominance in (South) Africa. New research examines women’s involvement in sport, specifically soccer and its impact on balance of gender power in South Africa on National, community and personal levels.

Women have up to a fourfold increase in risk of stillbirth following a previous stillbirth Women who have experienced a stillbirth have up to a fourfold increased risk of stillbirth in a second pregnancy compared to those who had an initial live birth

India's abortion law puts women at risk, should be changed, experts say Proposed amendments to India's abortion law are 'contradictory' and need 'urgent redrafting' to prevent women from making ill informed decisions and risking their lives with illegal terminations

Women in developed world still face many barriers to early abortion Women in developed countries still find it very difficult to get an abortion in early pregnancy, despite facing fewer legal constraints than in other parts of the world.

Aspirin Does Not Prevent Pregnancy Loss,

Increased live birth rate in subgroup of participants

A daily low dose of aspirin does not appear to prevent subsequent pregnancy loss among women with a history of one or two prior pregnancy losses, according to researchers at the National Institutes of Health.

However, in a smaller group of women who had experienced a single recent pregnancy loss, aspirin increased the likelihood of becoming pregnant and having a live birth.

Many health care providers prescribe low dose aspirin therapy for women who have had a pregnancy loss (miscarriage or stillbirth), and who would like to get pregnant again.  However, the effectiveness of this treatment has not been proven, the researchers wrote.

In the largest study of its kind, the researchers randomly assigned more than 1,000 women with a history of pregnancy loss to either daily low dose aspirin or a placebo.  The women began taking the equivalent of one low dose aspirin (81 milligrams) each day while trying to conceive.  The researchers reported that, overall, there was no difference in pregnancy loss rates between the two groups.

“Our results indicate that aspirin is not effective for reducing the chances of pregnancy loss in most cases,” said first author Enrique Schisterman, Ph.D., Chief of the Epidemiology Branch at the Eunice Kennedy Shriver National Institute of Child Health and Human Development,

Dr. Schisterman, added, however, that additional research was needed to investigate the finding that women who had experienced a single, recent pregnancy loss (before 4 1/2 months of pregnancy and within the past year) had an increased rate of pregnancy and live birth while on aspirin therapy.

Among this group, 78 percent of those who took aspirin became pregnant, compared with 66 percent of those who took the placebo.  For this subset of women, 62 percent of the aspirin group and 53 percent of the placebo group gave birth.

The study authors hypothesized that aspirin therapy might increase the conception rate by increasing blood flow to the uterus.  The researchers called for additional research to determine if aspirin therapy might be helpful for improving fertility in other subgroups as well, such as women who can’t establish a pregnancy because the embryo fails to implant in the uterus.

The researchers referred to their study as the Effects of Aspirin in Gestation and Reproduction trial. The study took place at four university medical centers over a five-year period.  Women participating in the trial were between 18 and 40 years of age and predominantly white. Participants took a daily dose of either aspirin and folic acid or placebo and folic acid. Folic acid is recommended for all women of childbearing age, because it reduces the risk for neural tube defects, a class of birth defects that can affect the brain and spine.

Women were followed for up to six menstrual cycles while they were trying to become pregnant and through pregnancy if they became pregnant. Aspirin was stopped at 36 weeks (about eight months) of gestation.

For the total number of women in the study, 13 percent of women who took aspirin and became pregnant subsequently experienced another loss, compared with 12 percent who took the placebo.  Ultimately, 58 percent of women taking aspirin and 53 percent of the placebo group got pregnant and later gave birth.