Genetics

Pregnancy Pathway, Pregnancy — Behavior: Avoiding Risks

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Some­times it seems like preg­nan­cy is a time of restric­tions. Avoid­ing risks can be one thing that makes it seem that way. But, bear with us here in an inter­est­ing trip through dan­ger and find­ing you find ways of enhanc­ing your preg­nan­cy!

Risk Fac­tor #1:

Lack of pre­na­tal care. More than any­thing else, be sure you have care. Hav­ing some­one mon­i­tor your health and that of your baby dur­ing preg­nan­cy is vital to a good out­come.

Risk Fac­tor #2:

Not exer­cis­ing. Seden­tary behav­ior increas­es the risk for meta­bol­ic, car­dio­vas­cu­lar and immune dis­or­ders.

I know, I know, you don’t have time to exer­cise. Well, pay now or pay lat­er, as they say. Make time to go to a class (make sure it includes 20 -30 min­utes of aer­o­bics) a cou­ple times a week. A class will also pro­vide social sup­port, anoth­er fac­tor that enhances your preg­nan­cy. Take a walk at lunch time. Prac­tice relax­ation tech­niques.

Risk Fac­tor #3:

Breath­ing dan­ger­ous fumes. Yes, this includes smok­ing and sec­ond-hand smoke. But, it also means avoid­ing envi­ron­ments where there is a lot smog (near high­ways), liv­ing with mold or dust, and fan­cy cleansers that may have dan­ger­ous chem­i­cals in them. Stick with vine­gar, ammo­nia or bleach as cleansers.

Smog can endanger your fetus!

Smog can endan­ger your fetus!

We are learn­ing that com­bus­tion exhaust from cars and trucks can neg­a­tive­ly affect birth weight and pre­ma­tu­ri­ty. If you live or work near a high­way or in an area where smog is preva­lent, what are your options? Can you trans­fer or move? Can you wear a mask? Talk to your care provider and fig­ure out the best pro­tec­tion for you and your fetus.

Risk Fac­tor #4:

Poor Nutri­tion. Yup, just go back one entry and find out how food affects preg­nan­cy. If you don’t eat enough pro­tein and drink enough water, you don’t make suf­fi­cient blood vol­ume to nour­ish your pla­cen­ta and thus your fetus.

Read labels!

Read labels!

Eat whole foods and learn to read labels when you buy processed foods. What is a “processed” food? Any­thing with more than one ingre­di­ent!

Some pro­cess­ing (ex: home­made soup) takes lit­tle nutri­tion away, but some pro­cess­ing (ex: pota­to chips) takes every­thing good away and replaces it with unsafe sub­stances. Look for low sodi­um, low sug­ar, high vit­a­min and min­er­al con­tent items with no sat­u­rat­ed or trans fats.

Read the ingre­di­ents; if you don’t know what the words mean, maybe you want to pass it up.

Risk Fac­tor #5:

Alco­hol and Drugs. Com­mon items can be as dan­ger­ous as street drugs, which

There is plenty of time in life for a glass of wine...later.

There is plen­ty of time in life for a glass of wine…later.

No. No. No. Only meds from your prenatal care provider are okay.

No. No. No. Only meds from your pre­na­tal care provider are okay.

Caffeine? Only one cup & only if you must.

Caf­feine? Only one cup & only if you must.

can severe­ly com­pro­mise you baby’s future. If you have a drug or alco­hol habit, get help.

Risk Fac­tor #6:

Genet­ics. You can have genet­ic pre­dis­po­si­tions for many preg­nan­cy issues. How­ev­er, that does not nec­es­sar­i­ly mean you will devel­op a giv­en dis­or­der. For exam­ple, nutri­tion and exer­cise great­ly reduce the risk and sever­i­ty of meta­bol­ic issues. Some genet­ic issues are unavoid­able how­ev­er, and your care provider will alert you to these, if they are rel­e­vant.

Risk Fac­tor #7:

Social issues — iso­la­tion, lack of sup­port, abuse, pover­ty. All of these fac­tors can have neg­a­tive effects.

If iso­la­tion is a sim­ple mat­ter of need­ing to meet oth­er moms-to-be, join an exer­cise pro­gram. That way, you get both sup­port and exer­cise; just be sure it includes aer­o­bics, along with cen­ter­ing, relax­ation and appro­pri­ate strength.

If your sit­u­a­tion is more dire, seek the help of a care provider or social work­er at your local hos­pi­tal or clin­ic. Safe­ty and sup­port are crit­i­cal for you at this time. Get the help you need. There are peo­ple who care. And, if you know of some­one who needs help, help them.

If you have oth­er risk fac­tors to offer, please post them in the com­ments. Thanks!

What’s next?  BIRTH!!

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 — Prior Sperm Exposure

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Today:  Sperm!!!

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

The mother's prior sperm exposure can affect her pregnancy.

The mother’s pri­or sperm expo­sure can affect her preg­nan­cy.

Not every sperm is your friend! Sperm expo­sure — like so many expo­sures — affects our immune sys­tem. Women who have babies with more than one father may be at risk for dis­or­ders of preg­nan­cy because the chal­lenges to their immune sys­tem have been exten­sive. And, very young women who become preg­nant are at increased risk of some dis­or­ders because they have had very lit­tle expo­sure to sperm.

In addi­tion, women who have pri­mar­i­ly and exten­sive­ly used bar­ri­er meth­ods of con­tra­cep­tion may be at risk for dis­or­ders for rea­sons sim­i­lar to young women with lit­tle expo­sure. Unlike women whose immune sys­tem has had too much chal­lenge due to preg­nan­cies by sev­er­al men, women with lit­tle expo­sure may not have a strong defense against for­eign DNA. Please do not take this as a rea­son to not use a con­dom — one of the bar­ri­er meth­ods along with a diaphragm and cer­vi­cal cap. Rather, if you use a bar­ri­er method of con­tra­cep­tion, keep in mind that your body’s adjust­ment to preg­nan­cy may take time.

For more infor­ma­tion on bar­ri­er meth­ods, to go the Amer­i­can Col­lege of Obste­tri­cians and Gyne­col­o­gists’ online pam­phlet: ACOG Pam­phlet on Bar­ri­er Con­tracetp­tion.

Anoth­er way sperm can affect the preg­nan­cy is that the com­bi­na­tion of the mother’s and father’s nat­ur­al immune respons­es may be strong against the tro­phoblast implan­ta­tion. This is not some­thing  you can know ahead of time. Also, women are eight times more like­ly than men to devel­op autoim­mune dis­or­ders. One rea­son may be the pre­na­tal expo­sure to for­eign DNA encoun­tered in preg­nan­cy.

Keep in mind that by get­ting good pre­na­tal care, exer­cise, suf­fi­cient rest, stress man­ag­ment and healthy nutri­tion, you do all with­in your pow­er to have a healthy preg­nan­cy. Your health care provider will deter­mine your risk fac­tors that may affect preg­nan­cy out­come and treat you in an appro­pri­ate man­ner.

Moms and babies enjoy exercise together!

Moms and babies enjoy exer­cise togeth­er!

Once your baby comes, there will be time to max­i­mize health for both of you. Exer­cis­ing togeth­er is great fun!

Get­ting there may require some patience, but the reward is well worth it.

When you are look­ing around for sperm, use your head. The same behav­ior that pro­tects you from infec­tions you nev­er want to get, pro­tects you from sperm you don’t real­ly want to meet. When the time comes to adopt some sperm, find out about it’s cre­den­tials!

Pregnancy Pathway, Conception — Health Status

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Today: How the mother’s health sta­tus at the time of con­cep­tion affects the preg­nan­cy.

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

The Impact of Health Status at the time of conception.

The Impact of Health Sta­tus at the time of con­cep­tion.

When a woman becomes preg­nant, her health can be a major fac­tor how her preg­nan­cy will pro­ceed. If she has been exposed to a vir­u­lent infec­tion, it may have an impact on how well the implan­ta­tion goes. If she has meta­bol­ic syn­drome, she is at risk for com­pli­ca­tions such as ges­ta­tion­al dia­betes.

On the oth­er hand, if she has tak­en care of her­self, is phys­i­cal­ly fit and well nour­ished, is well rest­ed and has not been exposed to ill­ness­es that induce dra­mat­ic changes in her immune sys­tem, she has done her best to cre­ate a sit­u­a­tion in which her body is best pre­pared for the rig­ors of preg­nan­cy.

There are still genet­ic and envi­ron­men­tal fac­tors that can affect the course of the preg­nan­cy, but behav­ior is the one fac­tor that women have con­trol over. At Danc­ing Thru Preg­nan­cy we are fond of the notion that if you know a cer­tain behav­ior is the best for a sit­u­a­tion, it is smart to chose that behav­ior; if you do not, you are sab­o­tag­ing your­self.

So, if preg­nan­cy is in your head­lights, eat right, exer­cise, and be cau­tious about expo­sure to ill­ness and infec­tion. Wash your hands, use one of the hand cleansers, prac­tice safe sex (okay, so if you are try­ing to get pg, this may change, but in the mean­time!).

We wel­come com­ments on what you are doing to be healthy for preg­nan­cy!

Curl-up! Strong abs are part of physical fitness!

Curl-up! Strong abs are part of phys­i­cal fit­ness!

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

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Please refer to Feb­ru­ary 5 entry for com­plete graph­ic. Today we turn to the ques­tion of pre­con­di­tions to preg­nan­cy and how they might affect mater­nal and off­spring health.

Preconditions

Pre­con­di­tions

Pre-exist­ing fac­tors that can influ­ence health out­comes include genet­ic fac­tors (fam­i­ly risk for heart dis­ease, for exam­ple), envi­ron­men­tal fac­tors (liv­ing in a build­ing with mold, for exam­ple), and behav­ior (eat­ing well and exer­cis­ing, for exam­ple). In each cat­e­go­ry, fac­tors will con­tribute to the health of the moth­er and even­tu­al­ly to off­spring health.

It is impor­tant to under­stand what major genet­ic fac­tors may affect your off­spring and whether the envi­ron­ment or behav­ior can help off­set neg­a­tive fac­tors. For exam­ple, there may be a his­to­ry of preeclamp­sia dur­ing preg­nan­cy in your fam­i­ly, but vig­or­ous aer­o­bic exer­cise in the six months pri­or to preg­nan­cy pro­vides a high degree of pro­tec­tion from this risk. Preeclamp­sia puts both moth­er and off­spring at risk for com­pli­ca­tions.

Oth­er genet­ic fac­tors that may be of con­se­quence include autoim­mune dis­or­ders, aller­gies, and meta­bol­ic syn­dromes. For exam­ple, so-called “thrifty genes” may pre­dis­pose you to a high weight gain in preg­nan­cy. But, you may be able to off­set health prob­lems asso­ci­at­ed with this by stay­ing active and eat­ing well.

Pregnancy Pathway, introduction

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Please refer to the Preg­nan­cy Path­way chart in the Feb­ru­ary 5, 2009 entry. Dur­ing preg­nan­cy, there are some fac­tors with­in our con­trol and some that are not. The Preg­nan­cy Path­way, designed by Danc­ing Thru Preg­nan­cy® founder and Yale Uni­ver­si­ty Move­ment Spe­cial­ist Ann Cowl­in, and Cer­ti­fied Nurse Mid­wife Robyn Bran­ca­to, is intend­ed to describe the flow of fac­tors that influ­ence preg­nan­cy and its out­come.

In the weeks to come, we will focus on indi­vid­ual areas. Our goal is to help women under­stand how they can opti­mize their preg­nan­cy by focus­ing on what they can con­trol that results in ben­e­fi­cial out­comes.

Ann and Robyn are also found­ing mem­bers of the Women’s Health Fit­ness Insti­tute, a non-prof­it orga­ni­za­tion whose mis­sion is research and pub­lic edu­ca­tion out­reach in women’s health fit­ness. Our com­ments for this blog are based on sci­en­tif­ic evi­dence and 30 years of track­ing indi­vid­ual preg­nan­cy out­comes from women through­out the world. Some entries will include ref­er­ences to the rel­e­vant stud­ies.

By help­ing women under­stand what endeav­ors are effec­tive in pro­duc­ing ben­e­fits for moth­ers and their off­spring, we hope to aid moms-to-be and those con­sid­er­ing preg­nan­cy to be ful­ly present and active in the empow­er­ing process of becom­ing a moth­er.