Painkillers in Pregnancy May Harm Son’s Fertility, Study Suggests

THURSDAY, Nov. 11 (HealthDay News) — Pregnant women who use mild painkillers may boost the risk that their male children will grow up to be infertile, a new European study suggests.

Commenting on the study, a U.S. researcher said the findings are weak, although he thinks pregnant women should be careful around painkillers, including aspirin, ibuprofen and acetaminophen, for another reason: miscarriages.

The European study, which included 834 women in Denmark and 1,463 in Finland, found that women who combined more than one mild painkiller at the same time were seven times more likely to give birth to sons with undescended testicles compared to women who took no painkillers.

In particular, the second trimester seemed to be the most vulnerable time, with any use of mild painkillers during that time period more than doubling the risk, the study authors noted in a news release from the European Society of Human Reproduction and Embryology.

Combining more than one painkiller during the second trimester increased the risk 16-fold, the investigators reported in the study published online Nov. 8 in the journal Human Reproduction.

It appears that it is becoming more common for males to have undescended testicles, particularly in Denmark, where the incidence has increased from 1.8 percent in 1959-1961 to 8.5 percent in 1997-2001, the study authors noted. The condition is thought to boost the risk of infertility and testicular cancer later in life. However, many males with undescended testicles grow up without these problems, they added.

In support of the findings, a study in rats by researchers from France and Denmark found that painkillers disrupt the endocrine system, changing the way the body produces testosterone.

“If exposure to endocrine disruptors is the mechanism behind the increasing reproductive problems among young men in the Western world, this research suggests that particular attention should be paid to the use of mild analgesics during pregnancy, as this could be a major reason for the problems,” research leader Dr. Henrik Leffers, a senior scientist at Rigshospitalet in Copenhagen Denmark, said in the news release.

“Women may want to try to reduce their analgesic use during pregnancy,” Leffers added. “However, as biologists this is not something we can advise women about. So we recommend that pregnant women seek advice from their physician before using mild analgesics and in general follow the advice to use as little medicine during pregnancy as possible.”

Commenting on the study findings, Dr. De-Kun Li, a senior research scientist at the Kaiser Foundation Research Institute in Oakland, Calif., said women should be cautious about painkillers during pregnancy because their use around conception has been linked to miscarriages. But Li said the new research is “relatively weak” for several reasons.

For one, Li said, the results from the two countries (Finland and Denmark) are inconsistent, and the condition in question — undescended testicles, also known as cryptorchidism — “is a tricky condition to determine.”

“Many boys can have undescended testicles at birth and then the condition will disappear [by] 1 year of age,” Li said. “Therefore, there is controversy over which cases should be really considered as cryptorchidism. Most studies only included those cases who remained cryptorchidism at age 1. But this study appeared to include all cases at birth. This raised the question whether those are real cases.”

Flu Vaccine recommended during Pregnancy

Yearly Flu vaccine is highly encouraged for all pregnant women. A recent study revealed that women who were vaccinated in the second or third trimester of pregnancy, their babies were significantly less likely to get the flu, and the babies’ blood showed evidence of antibodies to the flu. This study adds to the literature that vaccination in pregnancy is a “two for” because of the protection that it affords to infants younger than 6 months old who are vulnerable to influenza but not eligible for immunization. Please also note flu vaccination takes two weeks to become effective and lasts from six to eight months. Vaccination is safe in any trimester.

Serious complications including respiratory failure requiring ICU admission and maternal death are much more common in pregnancy due to generalized immune system suppression. If you recall last year’s HIN1 pandemic you should remember the numerous deaths that resulted and the much greater incidence in pregnant women than the general population.

Rest assured this year’s flu vaccine already includes HIN1 and cannot give you the flu as there is no live flu virus in the injectable form recommended during pregnancy. Any muscle aches or pains that patients claim have occurred after the injection are nothing compared to actually contracting the flu.

Get the flu vaccine during pregnancy… it’s not just for you but for your unborn and newborn baby too!

Doctor Jonathan Weinstein, an Ob-Gyn physician in Frisco, TX cares for patients that come from Frisco, Plano, McKinney, Allen and surrounding cities for all their obstetrical and gynecological needs.

Pregnancy-Related Weight Gain Higher Among Low-Income Minority Women

A new study by the Yale School of Public Health finds that excessive weight gain during pregnancy and inadequate postpartum weight loss are particularly prevalent among low-income, ethnic minority women. The study appears online in the journal American Journal of Obstetrics & Gynecology.

Patterns like this have important public health implications, including reduced growth for the fetus and greater likelihood of preterm delivery and injury during birth. Mothers who retain weight after giving birth are more likely than their peers to develop a range of serious health conditions, including cardiovascular disease, hypertension and diabetes.

The study followed 427 women (ranging in age from 14 to 25 years old) during their pregnancy through to 12 months postpartum. The researchers found that 62 percent of the women— particularly those who were already overweight or obese—exceeded the maximum recommended weight gain. Only 22 percent of the women gained weight within recommended guidelines.

Postpartum, the study found that one-third of the participants had a higher body mass index (BMI) one year after giving birth and that 68 percent were either overweight or obese. The study also found a noticeable shift toward obesity. Five percent of the women classified as having normal weight and 53 percent of those classified as overweight before pregnancy were classified as obese one-year postpartum. The authors note that a shift in body mass index that is seen after just one pregnancy is likely to be compounded with future pregnancies.

“Rates of overweight and obesity have increased dramatically in the United States and abroad. For childbearing women, obesity and excessive weight gain can result in serious adverse health outcomes for both mother and baby,” said Jeannette Ickovics, a professor at the School of Public Health and the paper’s senior author. “Pregnancy is a pivotal point for weight management. To promote good health, we must consider pregnancy a ‘window of opportunity’ for interventions to improve weight management and reduce the shift towards obesity.”

The Institute of Medicine released guidelines in 2009 on healthy levels of weight gain for pregnant women. They recommend that women who are considered underweight at the onset of their pregnancy gain no more than 40 pounds; that woman who are overweight gain no more than 25 pounds; and that women who are obese limit their overall weight gain to 20 pounds.

Other authors include Trace Kershaw, an associate professor at the School of Public Health; Bonnie E. Gould Rothberg, an associate research scientist in the Department of Pathology; Urania Magriples, an associate professor in the Department of Obstetrics and Gynecology; and Sharon Schindler Rising, executive director of the Centering Healthcare Institute in Cheshire, Conn.