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Pregnancy Pathway, Pregnancy — Maternal Immunological Response

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Today: Mater­nal Immuno­log­i­cal Response…or…the Mother/Fetus Dance!

Maternal Immune Response During Pregnancy

Mater­nal Immune Response Dur­ing Preg­nan­cy

Back to work! Thank you for your fore­bear­ance while we wrote a chap­ter for a nurs­ing text­book!

Dur­ing the course of preg­nan­cy, the mother/fetus dance is ongo­ing. The mater­nal immune sys­tem and the tro­phoblast cells con­tin­ue to influ­ence each oth­er even beyond the implan­ta­tion.

Because the mother’s immune response mod­u­lates near the start of each trimester, the fetus is affect­ed to some degree and mounts a response, as well. For a long time it was thought that mater­nal and fetal DNA mate­r­i­al was not exchanged across the pla­cen­tal mem­brane, how­ev­er recent find­ings indi­cate that there is some exchange of mate­r­i­al. Thus, we all car­ry some por­tion of our mother’s DNA and our moth­er car­ries some of ours.

What is the impact of this chimeric effect? It depends on how well our DNA gets along!

How does this affect the fetus in utero? The fetus may be affect­ed by clot­ting issues. Depend­ing on mater­nal health sta­tus s/he may be sub­ject to a stronger or weak­er immune sys­tem.

How does this affect the moth­er? Women are more like­ly than men to devel­op autoim­mune dis­or­ders (preg­nan­cy play­ing a role here), and those who bear male off­spring are more like­ly than those who only have girls to have these dis­or­ders.

The maternal/fetal dance goes on.…

Be Prepared for Birth!

Be Pre­pared for Birth!

Pregnancy Pathway, Conception — Review & Small Rant!

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REVIEW: Evi­dence is clear - pre-preg­nan­cy mater­nal health sta­tus, includ­ing phys­i­cal fit­ness, healthy nutri­tion and an uncom­pro­mised immune sys­tem affect the health and well-being of both moth­er and off­spring, in both short and long term.

This is the mes­sage sum­ma­ry from our first two areas of dis­cus­sion:  Pre­con­di­tions and Con­cep­tion — the green and sand col­ored sec­tions on the chart below.

pregnancy_pathway

COMING ATTRACTIONS: We are about to move on to the blue sec­tion — Preg­nan­cy!!  So, book­mark this Blog for future ref­er­ence!

Also, you can sub­scribe to this Blog by click­ing on Blog Info in the upper right cor­ner and then click­ing on Sub­scribe in the drop down menu.

But, yes, you guessed it, first we have a small rant!

SMALL RANT: When we note that fit­ness, nutri­tion and a healthy immune sys­tem play sig­nif­i­cant roles in the out­come of preg­nan­cy and the future health of moth­er and child, we are appeal­ing to young peo­ple of child­bear­ing age to be care­ful about your bod­ies. The alliance of egg and sperm shapes the world. With 6.5 Bil­lion egg/sperm com­bi­na­tions (yes, peo­ple) present­ly liv­ing on earth, our resources are stretched. With time, either we get more picky about doing this, or the 3rd rock from the sun (remem­ber that show?) is cooked.

Humor­ous incur­sion: In case you need fur­ther enlight­en­ment on this whole area, there is a great web­site that will help you out. Be pre­pared to be amused and amazed!

The Truth about Eggs and Sperm

Hope­ful­ly, this gets you in the right mood and keeps you smil­ing. After all, once you actu­al­ly are preg­nant, we have more seri­ous mat­ters to dis­cuss.

Pregnancy Pathway, Conception

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Today: Con­cep­tion!

For com­plete graph­ic, see Feb. 5 or 23 post.

bubblus_conception

The health of the moth­er and her pri­or expo­sure to sperm have a dra­mat­ic effect on con­cep­tion. To find out why and how, we have to start with this ques­tion: 

What is con­cep­tion?

Is it fer­til­iza­tion, a process by which an egg absorbs a sperm, engulf­ing the male’s half of the genet­ic code? Per­haps it is the point at which this egg/sperm con­coc­tion (the cor­pus) reach­es the uterus and the tro­phoblast cells begin to invade the endometri­um (uter­ine lin­ing)?

Trophoblast Invastion? No...Chihuly glass exhibit at the Desert Botanical Gardens, Phoenix AZ

Tro­phoblast Invas­tion? No…Chihuly glass exhib­it at the Desert Botan­i­cal Gar­dens, Phoenix AZ

Tro­phoblast inva­sion caus­es spi­ral arter­ies in the mother’s cir­cu­la­tion to open and form a pool that will nour­ish the fetus. Depend­ing on the “dis­cus­sion” between the mother’s immune sys­tem and tro­phoblast, this inva­sion may go well or poor­ly. How well it goes will affect the course of the preg­nan­cy.

Or, what about the point around 8 weeks post onset of last men­stru­al cycle at which the respon­si­bil­i­ty for nour­ish­ment of these cells is trans­ferred from the cor­pus to the pla­cen­ta? By this point about 30% of poten­tial preg­nan­cies have spon­ta­neous­ly abort­ed because of genet­ic or inflam­ma­tion prob­lems.

Anoth­er can­di­date is the Quick­en­ing, the point the Bible refers to as the start of life. This is  the occa­sion — around 4 months post onset of last men­stru­al cycle — when the moth­er first sens­es move­ment in her womb. Is this con­cep­tion? It cer­tain­ly ris­es to the test of con­scious­ness of a phe­nom­e­non (oth­er­wise known as a con­cept).

What if the engulf­ing of the sperm hap­pens in a dish in the lab­o­ra­to­ry? What if large dos­es of egg induc­ing med­ica­tions are required to prompt eggs to mature and con­sid­er engulf­ing sperm? What if hor­mones are required to allow the first few cells to grav­i­tate toward and inbed them­selves into a uter­ine sur­face not real­ly that friend­ly to their con­tin­u­a­tion?

You can see that it is not a sim­ple mat­ter to estab­lish a start­ing point. There are sev­er­al process­es that must go right to form a viable human. All along the way, the mother’s health plays a key role. Inter­est­ing­ly, the extent of expo­sure to the father’s sperm also plays a role, as do immune fac­tors in the com­bined mother’s and father’s genes.

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Most impor­tant for our         pur­pos­es here is that women who are reg­u­lar aer­o­bic exer­cis­ers pri­or to preg­nan­cy or who begin in ear­ly preg­nan­cy show reduced risk for devel­op­ments of the pla­cen­ta that pro­duce a dys­func­tion­al preg­nan­cy.

Upcom­ing posts will dis­cuss mater­nal health and sperm expo­sure in more detail.

Pregnancy — 50% planned; 50% unplanned

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So…are you plan­ning to become preg­nant? For the last decade, preg­nan­cy has been in a 50/50 sit­u­a­tion. That is, about half the preg­nan­cies occur­ring in the U.S. are planned. The rest? Well, not nec­es­sar­i­ly unwel­come, but def­i­nite­ly unplanned.

Will this change in the cur­rent reces­sion (or as a friend said today, Let us just call it a depres­sion and move on)? So far, it is clear that preg­nan­cy rates are not drop­ping, despite an unwill­ing­ness to spend mon­ey on many oth­er things. What does this say?

Once again, despite liv­ing in a high tech world, hav­ing babies is a pri­mal expe­ri­ence. It does not dimin­ish when resources are scarce.

So, plan to or not, if you have a baby dur­ing this depres­sion, do not waste your mon­ey. Fig­ure out how to have a healthy preg­nan­cy.

Next on the Preg­nan­cy Path­way: the act of con­cep­tion.

Small Rant, Review, References & Coming Attractions

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Small Rant — Women, their preg­nan­cies, births and moth­er­ing styles are all unique. The big issue in child­bear­ing these days is con­trol. Fear of los­ing con­trol, who con­trols birth (do YOU give birth or are you deliv­ered by oth­ers?), hav­ing the self con­fi­dence and skills to know when to let go of con­trol yet be okay. It’s inter­est­ing to hear what hap­pened to some­one else, but (here’s the rant part) this can often be fright­en­ing because — let’s face it — cat­a­stro­phe gets our atten­tion. What­ev­er you’ve heard, you still have to do it your­self. Preg­nan­cy, birth and par­ent­ing cre­ate a steep learn­ing curve.

Review — Our job at the DTP Blog is to help with the learn­ing curve through evi­dence-based infor­ma­tion. We are mov­ing along a path­way. Here it is, in a small ver­sion (see Feb. 5 for full ver­sion):
pregnancy_pathway

So far, we have dealt with Pre­con­di­tions (the Green items). If you under­stand what you can and can­not con­trol along your Preg­nan­cy Path­way it can help pre­vent you from spin­ning your wheels or wast­ing mon­ey. Some things are worth doing (self care, good food, exer­cise) and some are not (self-indul­gence, tox­ins, stress). Pre­con­di­tions to preg­nan­cy — genet­ics, envi­ron­ment and behav­ior — are worth pay­ing atten­tion to if you are of child­bear­ing age and think or know you are mov­ing along this path­way.

Ref­er­ences - We have used hun­dreds so far and will use many, many more, but only some of you will find the sci­ence some­thing you want to pur­sue, so please go to our DTP web­site (use the Blogroll) for more infor­ma­tion on research in this field. Here are some texts that explain much more: “Women and Exer­cise” in Varney’s Mid­wifery (edi­tions 3, 4 & 5), Jones & Bartlett Pub.; Women’s Fit­ness Pro­gram Devel­op­ment by Ann Cowl­in, Human Kinet­ics Pub.; and Immunol­o­gy of Preg­nan­cy by Gil Mor, Springer Pub.

Com­ing Attrac­tions — next, we talk about con­cep­tion. Yes, this is an excit­ing part, though not per­haps why you think (!). It turns out con­cep­tion is fraught with many twists and turns.

Humor­ous incur­sion:
Q: Why does it take a mil­lion sperm to fer­til­ize just one egg?
A: Because none of them will stop and ask direc­tions.
[Sor­ry, couldn’t resist.]

After that we will like­ly rant and review again, have more humor­ous incur­sions, pro­ceed on to the preg­nan­cy and birth expe­ri­ences, then dis­cuss health out­comes for mom and baby in the short and long term.

Why do we spend our time on this? From a bio­log­i­cal per­spec­tive, humans can do noth­ing more impor­tant than cre­ate healthy off­spring. Wars may be fought, the banks fail or cars become a thing of the past; we might even become post-racial; but, hav­ing babies doesn’t real­ly change. It remains a pri­mal expe­ri­ence. It’s nes­tled in a high tech world, but its still pri­mal. Women have always had guides; we take this role seri­ous­ly.

Stay tuned!!

Pregnancy Pathway, Preconditions — Environment

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Please refer to Feb­ru­ary 5 entry for entire graph­ic. Today: Envi­ron­men­tal Pre­con­di­tions to Preg­nan­cy.
bubblus_preconditions-environment
Our envi­ron­ment is with us all the time. Even if we think we are pre­vent­ing or con­trol­ling envi­ron­men­tal fac­tors that impinge on our bod­ies and minds, they are lurk­ing here, there, every­where, and they are myr­i­ad. Our envi­ron­men­tal influ­ences are every­thing from the air we breathe to the per­sons who raise or teach us, from the food avail­able to our hous­ing, from our job stress­es to cul­tur­al forces or even the weath­er in our part of the world. These things help shape who we are phys­i­cal­ly and men­tal­ly, over the long term and from moment to moment.

08-4Are you pre­pared to become a par­ent? One way to tell is to look at your environment…is it healthy? Are you liv­ing in a sit­u­a­tion that you can count on? What about clean air, safe paint or safe food? What about water? What about peo­ple around you? Are they sup­port­ive? Does your envi­ron­ment help you stay healthy?

What about your body? Fac­tors in the envi­ron­ment that affect fer­til­i­ty (or lack of it) may deter­mine if  you can even become preg­nant, or when you can become preg­nant. Think about this:  Women who work togeth­er often cycle togeth­er. What if you work alone, say at home…does this affect your ovu­la­tion? One fac­tor iden­ti­fied in the low­er­ing age of men­stru­a­tion in girls is the increas­ing num­ber of hor­mones in var­i­ous meats. Anoth­er fac­tor is the pres­ence of non-bio­log­i­cal­ly relat­ed old­er males in the house­hold. If these things are known, imag­ine what is not known about sit­u­a­tions, chem­i­cals or peo­ple in our envi­ron­ment that affect our repro­duc­tion!

There is not an absolute sep­a­ra­tion of genet­ics, envi­ron­ment and behav­ior. If we are genet­i­cal­ly pre­dis­posed to cer­tain dis­or­ders, for exam­ple, we may or may not devel­op them, depend­ing on envi­ron­ment. Some per­sons are inclined toward autoim­mune dis­or­ders, but they may do well or poor­ly depend­ing on the air pol­lu­tion where they live. Some indi­vid­u­als may devel­op immune dis­or­ders. And, this sit­u­a­tion may adverse­ly impact inflam­ma­to­ry respons­es dur­ing implan­ta­tion.

Peo­ple who strive to take care of them­selves even if they live in hor­ri­ble con­di­tions can use their behav­ior to improve their chances for suc­cess in every­thing from a healthy preg­nan­cy to a mean­ing­ful exis­tence. Even if genet­ics and the envi­ron­ment are against the process, behav­ior can some­times over­come the odds. Grant­ed, it’s not like­ly you can pro­duce 6′5″ off­spring (see last post on genet­ics!) if the egg per­son is 5′2″ and the sperm per­son is 5′7″, but much is pos­si­ble beyond that.

So, what do you do about your envi­ron­ment if you are think­ing about becom­ing preg­nant? Take stock. Ask your­self what, if any­thing, might have to change. Ask what you can or can’t accept for your off­spring, if you know there are envi­ron­men­tal fac­tors that aren’t per­fect. Fetus­es are amaz­ing crea­tures; the pla­cen­tas that sup­ply and defend them are ruth­less and will pro­tect a fetus at all costs. But, you can give your body and poten­tial baby a good chance to do well by pro­vid­ing a six month span of a healthy envi­ron­ment lead­ing up to con­cep­tion. And, healthy for mind as well as body.

When your baby comes into the world, a door opens in your heart to a room you didn’t even know was there. In that room is a cer­tain kind of love and car­ing that can­not be described. It is love for this being who is and isn’t you. As a moth­er, you have been her/his envi­ron­ment for nine months or how­ev­er long you have shared. The womb is a small, pro­tect­ed, orga­nized envi­ron­ment, one that reflects your larg­er envi­ron­ment. So, take stock now, ahead of time.

Pregnancy Pathway, Preconditions — Genetics

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Please refer to Feb­ru­ary 5 entry for com­plete graph­ic. The Pre­con­di­tion we will dis­cuss today is Genet­ics.

bubblus_preconditions_-_genetics

There are genet­ic fac­tors total­ly out­side your con­trol that deter­mine things as sim­ple as your offspring’s hair or eye col­or, how the ear­lobe attach­es to the side of the head and whether or not s/he can roll the tongue. More com­plex things, such as a pre­dis­po­si­tion to types of can­cers, bleed­ing dis­or­ders or var­i­ous oth­er dis­eases, also have a genet­ic basis.

Because the male con­tributes the sex of the off­spring, once con­cep­tion hap­pens, the sex off the fetus is deter­mined — at least genet­i­cal­ly. But, it turns out not every­thing genet­ic is set in stone. In utero, hor­mone expo­sures may affect how male and female char­ac­ter­is­tics devel­op, so that some girls will be very girlie, some will be tomboys, and some may be gay. A sim­i­lar effect will influ­ence how boys devel­op.

Genet­ic, envi­ron­men­tal and behav­ioral pre­con­di­tions can be  inter­twined. Envi­ron­men­tal fac­tors can alter genes, caus­ing them to express pro­teins that would oth­er­wise be dor­mant. Like­wise, our behav­ior affects some of our genes. If we have a fam­i­ly propen­si­ty for heart dis­ease, but we eat a healthy diet, exer­cise and avoid risky behav­iors, we alter the impact of our genet­ic code.

Keep in mind that some things will be com­plete­ly deter­mined by genes. It is not rea­son­able to hope, for exam­ple, that our off­spring will be 6′5″ if both par­ents are short (or vice ver­sa). If the moth­er has “thrifty genes” — that is, genes that make it easy for her to gain weight — she may well do so dur­ing preg­nan­cy, even if she fol­lows a rea­son­ably healthy lifestyle. If the immune sys­tems of both par­ents have some sim­i­lar­i­ties, it may affect the mater­nal immune response to the implant­i­ng tro­phoblast cells, thus affect­ing the pla­cen­ta and, indeed, the entire preg­nan­cy.

So, how do we advise peo­ple who are think­ing of preg­nan­cy to pre­pare them­selves for a healthy preg­nan­cy genet­i­cal­ly? Sure­ly, to deter­mine all the poten­tial genet­ic pos­si­bil­i­ties is not fea­si­ble or afford­able at this point. Maybe in anoth­er cen­tu­ry! But, we can know some fac­tors:  Is there sick­le cell ane­mia in both fam­i­lies? Is there a Mediter­ranean type of sick­le cell dis­or­der? What about clot­ting fac­tors or dif­fer­ences in Rh? What about dis­eases or dis­or­ders that are not com­mon, like ALS? These are things that poten­tial par­ents may want to dis­cuss.

Like so much of life, we can’t know every­thing. There are no guar­an­tees. There is a lot to be learned still about human genes and how they work.

This blog has at its heart the notion that phys­i­cal activ­i­ty has tremen­dous ben­e­fits for moth­er and offspring…and for part­ners, too. How does the genet­ic com­po­nent affect this? First, pre­con­cep­tion fit­ness low­ers some risk fac­tors for moth­ers and babies. Sec­ond, each mother’s genes will make it eas­i­er or more dif­fi­cult for her to enjoy or ben­e­fit from the activ­i­ty of exer­cise. We appre­ci­ate this and encour­age young moms-to-be to find some­thing enjoy­able that you like doing and find peo­ple or sit­u­a­tions that sup­port you in being active now before you become preg­nant.

If you need assis­tance or advice, please go to www.dancingthrupregnancy.com (use the BlogRoll)

Find Ask the Expert under the Con­sumer menu. Let us know how we can help!