October 13th, 2009 
Treating pregnant mothers, and then their infants, with select strains of probiotics — bacteria present naturally in the body and sometimes added to food or dietary supplements to boost immune function — may help prevent a skin condition known as eczema in children with a family history of allergies, particularly during the first 3 months of life, Dutch researchers report.
Eczema is an inflammatory skin condition thought to be related to allergies. Researchers gave more than 150 pregnant women with a family history of allergic diseases either a mixture of three probiotic bacteria or a placebo – inactive pill – during the last six weeks of pregnancy. They also gave the same treatment to the women’s children for 12 months.
Neither the women nor their doctors knew whether they were receiving the probiotics or inactive pills.
They were able to follow up with 102 of the children born to the mothers who took part in the study. During the first 3 months of life, the parents of six in 50 of the subjects who received probiotics reported eczema in their children, compared to 15 or 52 of the placebo group, according to a report of the study in the journal Allergy.
Although the rate of eczema in the two groups became more similar, there was still some benefit after for up to two years.
Put another way, it would be necessary to treat approximately 6 mothers and children to prevent one case of eczema at the age of three months and 12 months, and closer to 7 children at two years.
One of the paper’s 9 authors is employed by Winclove Bio Industries B.V., Amsterdam, which manufactures the probiotic supplements used in the study.
Related
- 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.”
- Siblings key in pregnancy-related diabetes risk
Women with a family history of diabetes who are free from the disease themselves are more likely to develop pregnancy-related diabetes, a new study confirms.
And the risks associated with having a brother or sister who is diabetic are much higher than having one or even two parents with the disease, Dr. Catherine Kim of the University of Michigan Medical School in Ann Arbor and her colleagues found.
The increased demands placed on the body during pregnancy can cause some women to develop abnormally high blood sugar. The condition, known medically as gestational diabetes, typically gets better after a woman delivers her baby, but it increases her risk of developing type 2 diabetes later on.
The more relatives a person has with type 2 diabetes, the greater their risk of developing the condition themselves. But little is known about how a woman’s family history of the condition affects her risk of developing gestational diabetes.
To investigate, Kim and her team looked at 4,566 women participating in the National Health and Nutrition Examination Survey, all of whom had at least one child. Ninety-seven percent had never been diagnosed with diabetes, about 1 percent had gestational diabetes only, and 2 percent had type 2 diabetes.
Having a mother or father with diabetes increased the likelihood of having diabetes or gestational diabetes to a similar degree, the researchers report in the American Journal of Obstetrics and Gynecology. But while having two parents with diabetes boosted the likelihood of having diabetes eight-fold, this only doubled the likelihood of gestational diabetes.
On the other hand, having a diabetic brother or sister increased gestational diabetes risk more than seven-fold, but only slightly upped type 2 diabetes risk.
“The odds of increased most markedly when a sibling was affected,” Kim and her team write. And when the researchers accounted for early-life factors such as education and poverty, the risk associated with having a diabetic sibling actually increased. “Sibling-only history may be a greater risk factor than previously documented,” they say.
The findings suggest, the researchers say, that gestational diabetes may follow a different pattern of inheritance than type 2 diabetes, which is closely associated with being overweight or obese.
Further investigation of these patterns could help identify women who are at particularly high risk of developing type 2 diabetes after having the gestational form of the condition, they add, “and thus target them for future prevention interventions.”
- Prevent Food Allergies in Babies During Pregnancy
If one child has food allergies, how can a pregnant woman help ensure her next child won’t be affected too?
By avoiding exposure to the food her child is allergic is to – starting in the third trimester and continuing into the second year of life, say researchers from Royal Prince Alfred Hospital in Camperdown, Australia.
Seven out of 10 babies born to mothers who took avoidance measures had no food allergies vs. 45% of babies whose moms did not follow the doctors’ advice, says pediatrician and study leader Velencia Soutter, MD.
That means eliminating the offending food not only from the diet but also from the environment, she says.
“Take peanut allergies, for example. If someone eats a lot of peanuts in your house, there is going to be aerosolized peanut protein in the environment. You need a clean household,” Soutter tells WebMD.
Soutter says she undertook the study because “parents of kids with food allergies came to us asking, ‘What can we do so this doesn’t happen again?’ They were desperate.”
The study involved 274 pregnant mothers of children with peanut, egg, or milk allergies.
“We didn’t tell them what to do, but gave them a lot of advice about how to avoid the food [their child was allergic to]. We started in the third trimester so everything would be in place when the baby was born,” she says.
The women were also encouraged to breastfeed, which has been shown to protect against the development of allergies in some studies, Soutter says.
About two-thirds of the women followed their advice.
At 1 and 1/2 and 3 years of age, the babies were evaluated for symptoms of allergic disease and given skin prick tests to determine if they showed susceptibility to the same food allergies as their older siblings.
“The results were dramatic,” Soutter says.
Thirty percent of babies born to mothers who took avoidance measures had one or more food allergies vs. 55% of babies whose moms didn’t take those avoidance measures.
Babies born to mothers who took avoidance measures were less likely to develop symptoms of asthma: Only 11% exhibited symptoms by the age of 3, compared with 43% of babies whose mothers didn’t avoid the offending foods.
Robert Wood, MD, director of the division of pediatric allergy and immunology at Johns Hopkins University School of Medicine in Baltimore, tells WebMD that pregnant women should not feel guilty if they do not want to follow avoidance measures.
“I explain to my patients that exposure [to food allergens] in pregnancy seems to be a risk factor in some studies, but the results are not consistent. We don’t have the answer,” he says.
- High blood pressure in pregnancy a heart risk
Women who had an increase in blood pressure during pregnancy are likely to develop heart disease at an earlier age than women who maintained normal blood pressure while they were pregnant, Chilean researchers report.
Dr. Gloria Valdes of Pontificia Universidad Catolica, Santiago and colleagues studied 217 women with an average age of about 61 years, who underwent a coronary artery examination about 30 years after their last pregnancy.
As reported in the medical journal Hypertension, 146 women had had normal blood pressure during their pregnancies while 71 women had hypertension during at least one pregnancy.
About half of all the participants were found to have significant coronary artery disease. Valdes told Reuters Health that women with hypertensive pregnancies developed significant narrowing in their coronary arteries about three years sooner than women with normal blood pressure during pregnancy.
Furthermore, during 10 years of follow-up, there was a significantly greater increase in the number of clogged arteries in the hypertensive group (28 percent) than in the normal blood pressure group (22 percent).
“Gestational hypertension represents a positive stress test for future cardiovascular risk, which should prompt early management of cardiovascular risks,” Valdes commented.
She added, “Obstetricians need to identify women with a family history of premature cardiovascular disease, as this doubles the risk of a hypertensive pregnancy.”
- High blood pressure in pregnancy a heart risk
Women who had an increase in blood pressure during pregnancy are likely to develop heart disease at an earlier age than women who maintained normal blood pressure while they were pregnant, Chilean researchers report.
Dr. Gloria Valdes of Pontificia Universidad Catolica, Santiago and colleagues studied 217 women with an average age of about 61 years, who underwent a coronary artery examination about 30 years after their last pregnancy.
As reported in the medical journal Hypertension, 146 women had had normal blood pressure during their pregnancies while 71 women had hypertension during at least one pregnancy.
About half of all the participants were found to have significant coronary artery disease. Valdes told Reuters Health that women with hypertensive pregnancies developed significant narrowing in their coronary arteries about three years sooner than women with normal blood pressure during pregnancy.
Furthermore, during 10 years of follow-up, there was a significantly greater increase in the number of clogged arteries in the hypertensive group (28 percent) than in the normal blood pressure group (22 percent).
“Gestational hypertension represents a positive stress test for future cardiovascular risk, which should prompt early management of cardiovascular risks,” Valdes commented.
She added, “Obstetricians need to identify women with a family history of premature cardiovascular disease, as this doubles the risk of a hypertensive pregnancy.”
