August 3rd, 2009 
According to a latest study, consuming alcohol during pregnancy and small body size at birth may perhaps predict poorer sleep and increased chances of sleep disorders in 8-year-old children born at term. At least that’s what experts from the organization of American Academy of Sleep Medicine have to say.
These findings are clinically important, as poor sleep and sleep disturbances in children are believed to be linked with various diseases. These seem to include obesity, depressive symptoms, attention deficit hyperactivity disorder, and poor neurobehavioral functioning.
The findings indicated that lower weight and shorter length at birth seemed to be associated with lower sleep efficiency. In addition, a lower ponderal index appears to be related with the presence of sleep disturbances. This index is known to be an indicator of fetal growth status. It was further observed that, children with short sleep duration were more susceptible to have been born through Cesarean section in contrast to children who sleep for a longer period of time.
Chief investigator Katri Raikkonen, PhD, in the department of psychology at the University of Helsinki, Finland claimed that even low levels of weekly prenatal exposure to alcohol could have undesirable effects on sleep quantity and quality during childhood.
“The results were in accordance with the fetal origins of health and disease hypothesis and the many studies that have shown that adverse fetal environment may have lifelong influences on health and behavior. However, this is among the few studies that have reported associations between birth variables and sleep quality and quantity among an otherwise healthy population of children.” says Raikkonen.
To better understand this criterion, experts seemed to have collected information from nearly 289 children born at term from 37 to 42 weeks of gestation. Apparently, they objectively measured sleep duration and sleep efficiency with the help of actigraphy at 8 years of age for an average of 7.1 days. Sleep efficiency appears to be the actual sleep time divided by the time in bed. Also, parents were noted to have completed the Sleep Disturbance Scale for Children in order to report sleep problems and sleep disorder symptoms such as bedtime resistance and sleep disordered breathing.
The authors claimed that small body size at birth may possibly function as a basic indicator of disturbances in the fetal environment. Supposedly, small body size is associated with prematurity, intrauterine growth retardation, prenatal alcohol exposure and poorer sleep quality in children and young adults.
The findings further demonstrated that amongst children born healthy and at full-term, a direct relationship appears to exist between smaller body size at birth and poorer sleep quality eight years from birth.
The findings of the study revealed that the possibilities for low sleep efficiency seemed to have increased by about 70 percent for every standard variation decrease in weight at birth. Furthermore, it increased by more than 200 percent for every decrease in length. It was estimated that for every standard deviation decrease in ponderal index at birth, the risk of parent-reported sleep disorders increased by 40 percent.
However, associations were not confounded by various factors. These factors included sex, gestational length, prenatal and perinatal complications, body mass index (BMI) at eight years of age, asthma, allergies or parental socioeconomic condition.
The findings of the study have been published in the journal Sleep.
Related
- Smoking moms tied to lasting kids’ sleep woes
Mothers who smoke during pregnancy are more likely to have children with sleep problems from birth all the way through age 12, new research shows.
“The more cigarettes that mothers smoked during pregnancy, the more sleep problems the children had,” Dr. Kristen Stone of Women and Infants Hospital in Providence, Rhode Island, one of the study’s authors, told Reuters Health.
What’s more, while most of the women who smoked during pregnancy used at least one other drug, Stone and her team found that nicotine was the only substance associated with sleep problems.
Stone and colleagues from centers in Miami, Detroit, and Memphis are following nearly 1,400 children born in 1993, 1994 or 1995 to investigate the long-term effects of exposure to substances during pregnancy.
The current study included children for whom data was available up to age 12. Among the 808 study participants, 374 had been exposed to cocaine or opiates such as heroin before birth, while 434 had not.
Children’s mothers or other caregivers reported on whether a child had difficulty falling asleep and staying asleep during three periods: one month to four years of age; five to eight years, and nine to 12 years. Being exposed to cocaine, opiates, marijuana, or alcohol in the womb had no effect on a child’s risk of having sleep problems, but nicotine did, and problems were seen at each of the three time points.
The researchers do not report what percentage of children had sleeping problems, but used a common measure of such problems that assigns points for items such as talking in one’s sleep, sleepwalking, and having trouble falling asleep.
The link remained even after the researchers took into account factors such as socioeconomic status, whether or not a child had been abused, and whether the mother or caregiver smoked after the child was born.
The findings shouldn’t be seen as showing that prenatal use of alcohol and drugs aside from cigarettes isn’t as harmful to a child’s sleep as smoking in pregnancy, Stone noted. Cigarettes are different from other substances, she explained, in that a person who smokes will typically do so much more frequently than a drug abuser uses cocaine or opiates.
Further, she said, many of the mothers in the study were using multiple substances while they were pregnancy. “When those substances are inside of us at the same time, they basically become a whole new substance because of their interactions with each other,” she added. All of this makes it difficult to tease out the effects of nicotine and other drugs, according to the researcher.
When a child does have sleep problems, Stone said, “early and careful attention” to these issues can go along way toward helping that child sleep better.
“Even an emphasis on basic behavioral sleep education could serve those children well,” she added. “Doing that would then likely improve the daytime experience for those children as well.”
- Agricultural Chemical Spray Linked to Birth Defect Risk
There’s a link between a birth defect called gastroschisis and the agricultural chemical atrazine, a new study has found.
Gastroschisis is an abdominal wall defect in which the intestines, and sometimes other organs, develop outside the abdomen through an opening in the abdominal wall. The incidence of this birth defect, also called infant abdominal hernia, has doubled to quadrupled over the past 30 years.
In the new study, researchers at the University of Washington in Seattle investigated whether environmental exposures were a factor in a higher than normal number of cases in the eastern part of the state.
“Our state has about two times the national average number of cases of gastroschisis,” study co-author Dr. Sarah Waller said in a news release. “The life expectancy for fetuses with this diagnosis is better than 90 percent; however it requires delivery at a tertiary care center with immediate neonatal intervention, which often separates families and can cause serious financial and emotional stress.”
Waller and colleagues analyzed 805 cases of live-born infants with gastroschisis between 1987 and 2006, along with 3,616 normal infants who acted as controls. The researchers matched birth certificates with U.S. Geological Survey databases of agricultural spraying of atrazine, nitrates, and 2,4-dichlorophenoxyacetic acid.
Gastroschisis occurred more often among infants born to mothers who lived less than 25 kilometers (or about 15.5 miles) from the site of high surface water contamination with atrazine. There was no increased risk associated with the other chemicals. The study authors also found that the risk of gastroschisis was higher for women who conceived in the spring (March through May), when agricultural chemical use is more prevalent.
- Better Birth Weight for Babies of Exercisers
Regular exercise during pregnancy doesn’t change a mother’s body weight but does lead to a small reduction in the baby’s weight, a new study shows.
The findings are important because larger birth size is associated with higher risk for childhood obesity.
In a randomized trial of 84 first-time mothers, participants were assigned to either an exercise or a control group. Exercisers rode stationary bikes for 40 minutes, five days a week, while the other women just maintained their regular activity. The women began exercising in the 20th week of pregnancy and continued until at least week 36.
The exercise didn’t make any difference in the mother’s weight compared to mothers who weren’t exercising. But among mothers who didn’t exercise, their babies were an average of five ounces heavier than babies born to women who exercised during pregnancy. There also was no difference in the average length of the babies, according to the study published in the Journal of Clinical Endocrinology and Metabolism.
The study shows that moderate, regular aerobic exercise can have a meaningful effect on a baby’s birth weight without putting the pregnancy or child at risk.
- Preemie Birth Could Mean Weaker Bones as Adults
Adults who were born preterm with a very low birth weight have significantly lower bone mineral density than those who were born at full term, a Finnish study has found.
The researchers evaluated the skeletal health of 144 adults, aged 18 to 27, who were born preterm with very low birth weight.
Because they have much lower bone mineral density, these adults may be at increased risk for osteoporosis, said Dr. Petteri Hovi and colleagues at the National Institute for Health and Welfare in Helsinki.
The study appears online Aug. 24 in the journal PLoS Medicine.
- Omega-3 Supplements Don’t Reduce Risk of Preterm Birth
Omega-3 fatty acid supplements are believed to have many health benefits, but the one thing they can’t do is help women with a history of delivering their babies early carry their next child to full term, new research finds.
“The omega-3 did not add any benefit,” said study author Dr. Margaret Harper, an associate professor of obstetrics and gynecology at Wake Forest University School of Medicine, Winston-Salem, NC. The study appears in the February issue of Obstetrics & Gynecology.
Harper and her colleagues randomly assigned 852 pregnant women with a history of a preterm birth either to get a daily omega-3 supplement or a placebo beginning about week 16 to 22 and continuing through week 36 of gestation.
All women also received weekly intramuscular hormone injections of hydroxyprogesterone caproate, which has been shown to improve the chances of carrying a baby to term, Harper said.
Her team followed up to see which women delivered before 37 weeks. Full-term is defined as 37 weeks of completed gestation.
Delivery before 37 weeks occurred in 37.8 percent of those taking omega-3, and 41.6 percent of those in the placebo group, a small difference.
Prematurity is the leading cause of newborn death, the authors write in the report, and it is increasing in the United States. A woman who delivers one baby before term is more likely to deliver future babies early.
Harper’s team decided to study the value of the omega-3 supplements after conflicting findings about the value of the supplements for women at high risk of premature delivery. For those at low-risk, she said, the findings seem to agree that omega-3 supplements don’t further reduce the risk of preterm birth.
A recent large review of published studies found only one that showed benefit of the supplements in high-risk women, she said.
According to Harper, omega-3 fatty acids, when metabolized, are converted to much less potent biochemicals called prostaglandins, which make the uterus contract, than are omega-6 fatty acids — also essential fatty acids but typically over-eaten in Western diets. Adding omega-3s to an omega-6-heavy diet, so the thinking went, might result in better chances of carrying the baby to term.
Omega-3 supplements, in other research, have been found to help heart health, to lower blood pressure and to reduce the risk of abnormal heartbeats.
But in Harper’s study, she also noted that women getting omega-3 supplements were more likely to give birth to a baby with respiratory distress syndrome (RDS). While 59 babies (13.9 percent) of those in the omega-3 group had RDS, only 35 (8.7 percent) of those in the placebo group did. In other words, the omega-3 mothers’ babies were 1.6 times more likely to get RDS than infants born to mothers taking placebo. It’s the first time such a finding has been reported in clinical trials, the authors wrote.
“While the study’s results showed no difference, there is early evidence that omega-3 fatty acids are beneficial for fetal brain development, so women should still consider taking them, in conjunction with their doctor’s advice, despite what seems to be little benefit for the reduction of spontaneous preterm birth.”
