Showing posts with label drugs. Show all posts
Showing posts with label drugs. Show all posts
Friday, January 29, 2010
Sunday, January 24, 2010
Pot smoking during pregnancy may stunt fetal growth
NEW YORK (Reuters Health) - Women who smoke marijuana during pregnancy may impair their baby's growth and development in the womb, a new study suggests.
Poor fetal growth and reduced head circumference at birth are linked to an increased risk of problems with thinking, memory and behavior in childhood. Cigarette smoking during pregnancy is known to impair fetal growth, but studies on the potential effects of marijuana have been inconclusive.
For the new study, researchers in the Netherlands followed more than 7,000 pregnant women, 3 percent of whom acknowledged smoking marijuana at least during early pregnancy. They found that babies born to marijuana users tended to weigh less and have smaller heads than other infants.
What's more, the study found, the longer a woman had used marijuana during pregnancy, the stronger the impact on birth size -- suggesting that the drug itself was to blame.
And while most marijuana users in the study also smoked cigarettes, the drug appeared to have effects over and above those of tobacco. In fact, marijuana showed stronger effects on birth size than tobacco, the investigators report in the Journal of the American Academy of Child and Adolescent Psychiatry.
The findings suggest that marijuana use, even restricted to early pregnancy, may have irreversible effects on fetal growth, write the researchers, led by Hannan El Marroun of Erasmus University Medical Center in Rotterdam.
To prevent this, they add, women who smoke marijuana should quit before becoming pregnant.
The study included almost 7,500 pregnant women who were surveyed on their use of alcohol, tobacco and drugs, and had ultrasounds to chart fetal growth during the first, second and third trimesters.
Overall, 214 women said they had used marijuana before and during early pregnancy; 81 percent quit after learning they were pregnant, but 41 women continued to smoke marijuana throughout pregnancy.
The researchers found that, on average, marijuana users gave birth to smaller babies, particularly those who had used throughout pregnancy.
Women who had smoked only during early pregnancy had babies who were
156 grams -- about 5.5 ounces -- lighter than infants born to women who had not used the drug. Women who had continued to smoke past early pregnancy had babies who were 277 grams, or nearly 10 ounces, smaller.
Based on ultrasound, marijuana use only in early pregnancy impaired fetal growth by about 11 grams per week, while use throughout pregnancy slowed fetal growth by roughly 14 grams per week. That compared with a deficit of 4 grams per week with tobacco use, the researchers found.
Similar patterns were seen when the researchers looked at fetal head circumference.
According to El Marroun's team, mothers' marijuana use could stunt fetal growth for several reasons. Like tobacco smoking, it may deprive the fetus of oxygen. It is also possible that the byproducts of marijuana directly affect the developing nervous and hormonal systems of the fetus.
Finally, the researchers note, pregnant women who use marijuana may have other factors in their lives - such as a less-than-healthy diet or chronic stress -- that could contribute to poor fetal growth.
SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry, December 2009.
Poor fetal growth and reduced head circumference at birth are linked to an increased risk of problems with thinking, memory and behavior in childhood. Cigarette smoking during pregnancy is known to impair fetal growth, but studies on the potential effects of marijuana have been inconclusive.
For the new study, researchers in the Netherlands followed more than 7,000 pregnant women, 3 percent of whom acknowledged smoking marijuana at least during early pregnancy. They found that babies born to marijuana users tended to weigh less and have smaller heads than other infants.
What's more, the study found, the longer a woman had used marijuana during pregnancy, the stronger the impact on birth size -- suggesting that the drug itself was to blame.
And while most marijuana users in the study also smoked cigarettes, the drug appeared to have effects over and above those of tobacco. In fact, marijuana showed stronger effects on birth size than tobacco, the investigators report in the Journal of the American Academy of Child and Adolescent Psychiatry.
The findings suggest that marijuana use, even restricted to early pregnancy, may have irreversible effects on fetal growth, write the researchers, led by Hannan El Marroun of Erasmus University Medical Center in Rotterdam.
To prevent this, they add, women who smoke marijuana should quit before becoming pregnant.
The study included almost 7,500 pregnant women who were surveyed on their use of alcohol, tobacco and drugs, and had ultrasounds to chart fetal growth during the first, second and third trimesters.
Overall, 214 women said they had used marijuana before and during early pregnancy; 81 percent quit after learning they were pregnant, but 41 women continued to smoke marijuana throughout pregnancy.
The researchers found that, on average, marijuana users gave birth to smaller babies, particularly those who had used throughout pregnancy.
Women who had smoked only during early pregnancy had babies who were
156 grams -- about 5.5 ounces -- lighter than infants born to women who had not used the drug. Women who had continued to smoke past early pregnancy had babies who were 277 grams, or nearly 10 ounces, smaller.
Based on ultrasound, marijuana use only in early pregnancy impaired fetal growth by about 11 grams per week, while use throughout pregnancy slowed fetal growth by roughly 14 grams per week. That compared with a deficit of 4 grams per week with tobacco use, the researchers found.
Similar patterns were seen when the researchers looked at fetal head circumference.
According to El Marroun's team, mothers' marijuana use could stunt fetal growth for several reasons. Like tobacco smoking, it may deprive the fetus of oxygen. It is also possible that the byproducts of marijuana directly affect the developing nervous and hormonal systems of the fetus.
Finally, the researchers note, pregnant women who use marijuana may have other factors in their lives - such as a less-than-healthy diet or chronic stress -- that could contribute to poor fetal growth.
SOURCE: Journal of the American Academy of Child and Adolescent Psychiatry, December 2009.
Birth Drugs Impair Breastfeeding
Sunday, January 24, 2010 by: David Gutierrez
(NaturalNews) Drugs commonly given during hospital labor may impair a woman's ability to breastfeed, according to a study conducted by researchers from Swansea University and published in the journal BJOG.
"A lot of women are not given enough information about the medications that might be given to them during childbirth, and women at low risk of bleeding may not need to take these drugs," said Rosemary Dodds of the National (British) Childbirth Trust, who was not involved in the study. "It is important that women understand the risks and can give their informed consent before they go into labor."
Researchers examined data from 45,000 births in South Wales, finding that women who were given either oxytocin (also marketed as pitocin and syntocinon) or ergometrine (also known as ergonovine) were significantly less likely to begin breastfeeding within 48 hours of birth than women who were not given the drugs.
Oxytocin and ergometrine are regularly given to women in order to reduce their risk of postpartum hemorrhaging, even when the risk is already low. Oxytocin is also used in labor in order to stimulate contractions, but this use was not examined in the current study.
Among women who had not been given either drug following the delivery of their child, 65.5 percent began breastfeeding within 48 hours. Among women who had received oxytocin, only 59.1 percent did so, while only 54.6 percent of women who received both drugs began breastfeeding within 2 days.
The researchers suggested that the anti-bleeding drugs could interfere with milk production, thus making breastfeeding more difficult and causing new mothers to give up in frustration.
The study also found that high doses of painkillers known as epidurals also reduce a woman's chance of breastfeeding. Prior studies have also found this connection.
Breastfeeding has been linked to a number of significant lifelong health benefits for both mothers and infants.
Sources for this story include: news.bbc.co.uk.
(NaturalNews) Drugs commonly given during hospital labor may impair a woman's ability to breastfeed, according to a study conducted by researchers from Swansea University and published in the journal BJOG.
"A lot of women are not given enough information about the medications that might be given to them during childbirth, and women at low risk of bleeding may not need to take these drugs," said Rosemary Dodds of the National (British) Childbirth Trust, who was not involved in the study. "It is important that women understand the risks and can give their informed consent before they go into labor."
Researchers examined data from 45,000 births in South Wales, finding that women who were given either oxytocin (also marketed as pitocin and syntocinon) or ergometrine (also known as ergonovine) were significantly less likely to begin breastfeeding within 48 hours of birth than women who were not given the drugs.
Oxytocin and ergometrine are regularly given to women in order to reduce their risk of postpartum hemorrhaging, even when the risk is already low. Oxytocin is also used in labor in order to stimulate contractions, but this use was not examined in the current study.
Among women who had not been given either drug following the delivery of their child, 65.5 percent began breastfeeding within 48 hours. Among women who had received oxytocin, only 59.1 percent did so, while only 54.6 percent of women who received both drugs began breastfeeding within 2 days.
The researchers suggested that the anti-bleeding drugs could interfere with milk production, thus making breastfeeding more difficult and causing new mothers to give up in frustration.
The study also found that high doses of painkillers known as epidurals also reduce a woman's chance of breastfeeding. Prior studies have also found this connection.
Breastfeeding has been linked to a number of significant lifelong health benefits for both mothers and infants.
Sources for this story include: news.bbc.co.uk.
Friday, November 20, 2009
Birth Defects Associated with Use of Antibiotics During Pregnancy
Sulfonamides and nitrofurantoins were associated with birth defects.
Antibacterial drugs are among the most commonly used medications during pregnancy. Investigators analyzed data from a national birth defects study to compare antibiotic use in 13,155 mothers of infants with at least one major birth defect and 4941 randomly selected mothers of infants without birth defects from the same geographic region and born during the same period (1997–2003). Antibiotic use was determined by telephone interview 6 weeks to 2 years after the pregnancy. Exposure to antibiotics was defined as reported use during the month before the estimated date of conception through the end of the first trimester; 14% of cases and 13% of controls used antibiotics during this interval.
Sulfonamides were associated with six major birth defects, including anencephaly (odds ratio, 3.4) and hypoplastic left heart syndrome (OR, 3.2). Nitrofurantoins were associated with four birth defects (including hypoplastic left heart syndrome; OR, 4.2), and erythromycins were associated with two defects. Penicillins, cephalosporins, and quinolones each were associated with one defect.
Comment: The authors note the limitations of this retrospective study, including the major limitation that causality cannot be determined. However, the results are reassuring. Penicillins, erythromycins, and cephalosporins appear to be safe. Sulfonamides and nitrofurantoins appear to be associated with several birth defects and should be avoided if possible. Quinolones, used infrequently by women in this study, are not recommended for use during pregnancy.
Published in Journal Watch Pediatrics and Adolescent Medicine November 18, 2009
Citation(s):
Crider KS et al. Antibacterial medication use during pregnancy and risk of birth defects: National Birth Defects Prevention Study. Arch Pediatr Adolesc Med 2009 Nov; 163:978.
- Original article (Subscription may be required)
- Medline abstract (Free)
Wednesday, November 18, 2009
Friday, June 12, 2009
Pain Medications Used in Childbirth: Effects on Mother, Baby, Breastfeeding and Bonding
June 11, 2009 by
Denise Hibben The medications most commonly used in hospital labor and delivery wards in the US are: Demerol (meperidine), Morphine, Stadol (butorphanol), Fentanyl, Nubain(nalbuphine). It should be noted that Demerol and Morphine are not commonly used as much as Stadol, Fentanyl, and Nubain. The anesthetics that are more common in epidurals are Lidocaine (xylocaine), and Bupivicaine (marcaine, marcain).
The benefits are obvious to the relief of pain in childbirth... relief of pain. If a mother has been in labor for a very long time and is exhausted, an epidural can make the difference between a vaginal birth and a cesarean section, by allowing her some relief so she can sleep and gain new strength. Pain relief can relax a laboring mother enough that her contractions become more effective and allow her labor to progress more efficiently. In the rare case of soft tissue dystocia that is purely physiological, pain medications may resolve it, as long as there are no emotional factors to consider.
Let us go over some of the general adverse effects of using pain relief and epidurals during labor and birth. Keep in mind that these are the adverse effects that are general among all of the more commonly used medications. Both mother and baby can experience these: sleepiness, sedation, dizziness, constipation, sleep problems, insomnia, nausea, vomiting, stomach pain, diarrhea, loss of appetite, memory problems, sweaty, clammy skin, headache, breastfeeding difficulties, bonding difficulties, and withdrawal symptoms.
These are the less serious side effects of the pain medications commonly used.
Some of the more serious adverse effects include: increased need to resuscitate newborns at birth, breathing difficulties in mother and newborn, very rapid heartbeat, very slow heartbeat, confusion, seizures, hallucinations, severe allergic reactions, numbing of face and extremities. These adverse effects are seen in both the mother and the baby.
It is known that these pain medications cross the placenta and affect the baby before birth. Most women who birth in the hospital will be offered these medications sometime during their labor, unless you have specifically requested that these not be offered. Some studies show that 90% of
healthy, low-risk women who birth in hospitals will have narcotic pain medications and/or an epidural during labor. This means that 90% of healthy infants born in hospitals are born drugged! Clearly information has not been shared with these mothers of the side effects of these medications.
Babies who are exposed to narcotics have stress put on their kidneys and livers as they try to metabolize the drugs. This can cause problems as well, considering that their livers and kidneys are still immature.
Physiological effects of Epidurals in labor
Epidurals are used to numb the nerves from the waist down during childbirth. An anesthetic/narcotic combination is injected into the dural space of the spinal column via catheter, which is in place throughout labor and delivery. Granted it can be an extreme relief during the pain of labor, but it is known to increase the length of labor and the second (pushing) stage, the need for forceps or vacuum assisted birth, episiotomy, and c-section. Those have an entire range of risks in and of themselves. It is also known to cause maternal fever and low blood pressure.
Because a woman is numbed by the epidural, she is not able to get up and move around during labor. This can cause labor to last longer and she may not be able to push as effectively because she cannot feel where to push.
Pain Medications and Breastfeeding
It is known that all of the narcotic medications used in labor and birth are exuded in Breastmilk. This means not only is the newborn baby getting an adult dose during labor, but also with the first feeding. Hence the sleepy baby that is more commonly seen in hospitals. Babies born without narcotics have a better latch during breastfeeding, are more alert and responsive during the first hours after birth, have less feeding problems and crying spells in the first 8 weeks of life, and are in general healthier, happier, and more content. American Academy of Pediatrics has taken the position that it is safe to breastfeed after receiving narcotics during labor, although they have stated that if a mother is prescribed these medications after birth, while still breastfeeding, it is recommended that the risks to the baby and the benefits to the mother should be weighed before taking these medications.
Some medications are known to actually hinder successful breastfeeding; in fact the drug Fentanyl is one of these.
Pain Medications and Bonding
To put it simply, it is hard to bond with someone who is so drugged that they can't respond in a normal fashion to us. This is not to say that women who use pain medications in labor love their babies less, it is just harder to get to know them.
Babies who are exposed to pain medications during labor and birth actually spend more time away from their mothers in the first hours of life than their non-drugged counterparts. This is due to the aforementioned adverse effects caused by narcotics.
This article is not meant to be a scare tactic. It is simply meant to educate, and hopefully encourage research by pregnant women as to the medications used to relieve pain during labor and birth.
Sources
Drugs in Pregnancy and Lactation, 5th Ed
Maternal-Newborn Nursing, 7th Ed.
Medications and Mothers Milk, 12th Ed.
Varney's Midwifery, 4th Ed
www.rxlist.com
www.drugs.com
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8N-4G0M55R-3S&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=45b0c0e06fd406bfc694e8d4aa80a0db
http://www.redorbit.com/news/health/182842/fentanyl_during_labor_may_impede_breastfeeding/
http://www.medicalnewstoday.com/articles/58772.php
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