Obesity and Diabetes Link to Child Disorders

Obese women and those with Type 2 diabetes could be increasing their chances of having a child with autism or another development disorder, a US study suggests.

Researchers at the University of California Davis said that high glucose levels during pregnancy could affect brain development in the foetus.

The Paediatrics study looked at 1,000 children and mothers over seven years. Diabetes UK said further research was needed.

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In California, where the study was carried out, 1.3% of women have Type 2 diabetes and 7.4% have diabetes which developed during pregnancy.

The children in the study were aged between two and five years old and were enrolled between 2003 and 2010.

Obesity and Diabetes Link to Child Disorders

Among children whose mothers had Type 2 diabetes during their pregnancies, the study found that 9.3% of those children had autism. And 11.6% of that group of children showed evidence of a developmental disability.

This was nearly twice as high as the 6.4% of children with these problems born to women with no metabolic conditions.

Over 20% of the mothers of children with autism or other developmental disability were obese, compared with 14% of the mothers of normally developing children.

Communication skills

In the US, the study noted that 34% of women of child-bearing age are obese and nearly 9% are diabetic.

Around 29% of the children with autism had mothers with a metabolic condition during pregnancy, such as diabetes, high blood pressure and obesity.

Nearly 35% of the children with another developmental disorder had mothers with metabolic conditions, compared to 19% of children in the control group.

The study also examined the link between hypertension and autism or developmental disorder.

The prevalence of high blood pressure was low for all groups, but more common among mothers of children with autism or developmental disorder, although it was not statistically significant.

When analysing children’s cognitive abilities, the study found that among the children with autism, children of mothers with diabetes did not perform as well as children of non-diabetic mothers in tests of expressive language and communication skills.

And the presence of any metabolic condition was linked to lower scores on all of the tests among children without autism.

The authors say that obesity is a significant risk factor for diabetes and hypertension, and is characterized by increased insulin resistance.

Paula Krakowiak, from the MIND Institute at the University of California Davis, said: “Our finding that these maternal conditions may be linked with neurodevelopmental problems in children raises concerns and therefore may have serious public-health implications.”

Dr Matthew Hobbs, head of research at Diabetes UK, said more research was needed to answer questions not investigated in the study.

“It is important to note that while it does show an association, it does not show that diabetes causes developmental problems. We continue to advise that women with diabetes should tell their diabetes health care team if they are planning to become pregnant. They can then work together to make sure they are aware of the steps they should take to help them have a healthy pregnancy. “

Source: BBC News UK

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Cheap Device Reduces Premature Births

A cheap medical device can dramatically reduce the number of premature births in some at-risk women, according to a team of doctors in Spain.

Being born before 34 weeks of pregnancy is linked to a host of health problems.

The study, published in the Lancet, showed that using a “cervical pessary” reduced the rate in the at-risk group. Doctors said more studies were needed before the technique was used routinely.

Cheap Device Reduces Premature Births

The authors said 13 million babies were born prematurely every year.

In the trial, doctors were looking at women who had a cervix – part of the lower section of the uterus – which was shorter than 25mm. These pregnant women are thought to be at a higher risk of an early delivery.

The cervix was measured between 18 and 22 weeks into the pregnancy by an ultrasound scan. Of the 11,875 women who took part in the trial, 726 had a cervical length less than 25mm. Half of these women had a pessary, a small ring of silicone, inserted into their cervix.

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Pretty Amazing

In the group of women without the pessary, 27% of babies were born prematurely. The rate was six per cent among those fitted with a pessary.

Maria Goya, one of the researchers at the Vall d’Hebron Hospital, said: “Placement of a pessary is an affordable procedure, non-invasive, and easy to insert and remove as required.”

The study concluded the pessary was a “reliable alternative for prevention of preterm birth” in a group of at-risk women.

Prof Steve Thornton of the University of Exeter, a spokesman for the Royal College of Obstetricians and Gynaecologists, said: “The difference in the two groups is pretty amazing.”

He said more research was needed to prove that it worked, and to find out if it could help other women at risk of a premature birth. “If this is borne out it could make a big difference,” he added.

Drs Steve Caritis and Hyagriv Simhan, of the Magee Women’s Hospital in Pittsburgh, said the findings had “renewed enthusiasm for the cervix as a therapeutic target” in preventing premature births.

However, they warned that few women had a short cervical length, which made “this screening approach fairly inefficient”. They added: “Additional well-designed studies are needed before pessary use can be validated as an effective treatment.”

Source: BBC News UK

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Higher Birthweight Linked to Grandmother Gene

Scientists say a gene variation could contribute up to 155g (5.5oz) to a child’s birthweight.

The gene studied is believed to act as a growth suppressor, reducing birthweight.

But the UK-based researchers found a particular variant passed down from the mother can add 93g (3.3oz) to the birthweight, or 155g if passed down from the maternal grandmother.

Higher Birthweight Linked to Grandmother Gene

Details are published in the American Journal of Human Genetics.

Professor Gudrun Moore of University College London and colleagues looked at a gene called PHLDA2 in nearly 9,500 DNA samples taken from mothers and their babies, collected in three separate studies.

They found a gene variant called RS1 appeared to change the way in which the gene functioned, leading to higher birthweights.

“The gene is already known to have a profound effect on birthweight by acting as a growth suppressor,” Prof Moore told BBC News.  We have found a genetic variant of PHLDA2 that when inherited from the mother, causes the baby to be 93g bigger on average, or even 155g bigger on average, if inherited successively from the mother’s mother.”

The RS1 variation was found in around 13% of the individuals studied, with 87% possessing the RS2 variation.

“We suggest that the more common RS2 gene variation, which is only found in humans, has evolved to produce a smaller baby as a protective effect to enhance the mother’s survival during childbirth,” said Prof Moore.  Dad’s lack of involvement in evolutionary terms may stem from his own survival not being at stake and he can continue to reproduce with other females.”

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Gene Silenced

The PHLDA2 gene is unusual in that only the copy inherited from the mother is active, while the copy inherited from the father is “silenced”. This silencing of the paternal gene results from molecular processes around the DNA known as epigenetics.

Scientists do not know why, but have speculated that it is to ensure birthweight is reduced to ensure the mother survives childbirth.

Dr Caroline Relton of Newcastle University said: “Although this study looks only at birthweight as an outcome, it is possible that this genetic variant may have longer-term health consequences.

“Indeed the long-term health consequences associated with extremes of birthweight might be due in part to this and other contributory genetic factors.”

Source: BBC News UK

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Study Links Womb Environment to Childhood Obesity

New evidence has linked the environment in the womb with increased body weight in later life.

Scientists found changes around the DNA at birth which may result from a mother’s diet or exposure to pollution or stress. They then linked these changes to a higher Body Mass Index (BMI) in children aged about nine years of age.

But the researchers say more work is needed to definitively prove the link between these changes and obesity.

Study Links Womb Environment to Childhood Obesity

Details are published in the journal Plos One. Childhood or adult obesity has many causes, not least childhood or adult diet, but scientists have previously linked specific genes, such as the FTO gene, with increased body weight.

Others have looked at not the genes, but associated molecular changes – what are called epigenetics – which can play a role in how a gene functions in the body, switching genes on and off.

These changes are thought to be caused in part by exposure to environmental factors such as diet, stress, smoking or hormones, particularly in the womb and during early childhood.

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While epigenetic changes in the womb have already been associated with later obesity, there is still little data to prove the link.

Dr Caroline Relton, of Newcastle University, and colleagues took blood samples from 24 children aged 11 to 13 and looked for differences in the way genes are “expressed” or encoded into the many proteins which we need to grow and function.

They identified epigenetic changes in 29 genes which could be associated with higher body mass among the children. They then looked at data from a larger study of 178 individuals, for whom there were both cord blood samples from birth, and body composition data from aged about nine.

Among these individuals, epigenetic changes to nine of the 29 genes previously identified appeared to correspond to increased body weight, although only one of these associated changes withstood rigorous further analysis, admit the researchers.

“Other studies have just taken genes at birth and looked at differences irrespective of whether they are differently expressed with different levels of obesity,” Dr Relton told the BBC. The difference between this study and others is that we had a reason to focus on the genes we looked at because we knew they were differently expressed in children with a higher BMI.”

However, Dr Relton says more research is needed to prove the epigenetic differences observed at birth and originating in the womb, are actually contributing to obesity.

“While we have discovered an association between these genes and body size in childhood we need to carry out further studies to establish whether influencing the expression of these genes by altering epigenetic patterns is indeed a trigger to obesity.”

Early signals

Commenting on the paper, Prof Gudrun Moore of University College London told BBC News: “The paper is an interesting study on epigentic variations and their potential association with body size indices.”

Prof Tim Spector of King’s College London, said the paper represented “an exciting piece of research exploring new ways of looking at the causes of obesity.  Although it is limited by the small size and the fact that they only looked at 29 genes, the researchers found that a third of the genes they looked at contained epigenetic marks at birth that were related in some way to measures of later obesity. This means that chemical signals that turn genes on or off at birth can influence susceptibility to being fat at age 10.

“We know from differences in identical twins that genes and DNA are not the whole answer. Understanding how we could manipulate these signals in early life – via better understanding epigenetics – has great potential in battling the obesity epidemic,” he said.

 Source: BBC News UK

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Fewer Premature Births after Smoking Ban in Scotland

Since Scotland introduced a ban on smoking in public places in 2006 there has been a 10% drop in the country’s premature birth rate, say researchers.

They believe this is a smoke-free benefit that can be chalked up alongside others, like reductions in heart disease and childhood asthma.

Fewer Premature Births after Smoking Ban in Scotland

Tobacco smoke has been linked to poor foetal growth and placenta problems. Plos Medicine analysed smoking and birth rates for all expectant women in Scotland before and after the ban.

It included data for more than 700,000 women spanning a period of about 14 years.

 

Significant change

Scotland was the first country in the UK to ban smoking in public places, followed by Wales, Northern Ireland and England in 2007.

After the legislation was introduced in Scotland, fewer mothers-to-be smoked – 19% compared with 25% before. At the same time there was a significant drop in the number of babies born prematurely or with low birthweight.

The investigators believe both are linked to the smoking ban, even though these rates started to go down some months before the ban was introduced and smoking incidence started to creep up again shortly after the ban.

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They say there have not been any major changes in maternity care that would explain the findings.  Also, the reduction in premature births was both in non-smokers and women who continued to smoke when pregnant, which they say suggests passive smoke exposure is likely involved.

But while their work suggests a link, it is not proof that one thing necessarily causes another. As with all retrospective studies like this, it is impossible to rule out entirely all other factors that might have influenced the finding.

However, Dr Daniel Mackay and colleagues from the University of Glasgow say their findings “add to the growing evidence of the wide-ranging health benefits of smoke-free legislation” and “lend support” to the adoption of such legislation in countries where it does not currently exist.

Andy Cole, chief executive of the special care baby charity Bliss, said: “We welcome the findings of this new study, which highlights a reduction in the number of babies born early or with low birthweight in Scotland, where around 8,000 babies are born each year needing specialist hospital care.

“Bliss always recommends that women should not smoke during pregnancy and that they should lead a healthy lifestyle. However, it is important to remember that the reasons a baby can be born premature or underweight are complicated and that smoking is just one risk factor.”

According to the British Heart Foundation, there are more than nine million smokers in the UK, and smoking remains the UK’s biggest cause of avoidable early death.

It says the focus should now shift to the effect of smoking in the home and confined spaces, such as cars, especially where children are present.

A Scottish Government spokesman said: “We are continuing to build upon the achievements made to protect future generations from the devastating effects of smoking such as bans on cigarette vending machines and the displays in shops.  We are committed to ensuring a new comprehensive robust tobacco control strategy for Scotland is developed this year. This strategy will focus on prevention and cessation and include ambitious targets for reducing smoking across Scotland.”

Source: BBC News UK

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Unlimited Human Eggs ‘Potential’ for Fertility Treatment

It may be possible to one day create an “unlimited” supply of human eggs to aid fertility treatment, US doctors say.

Researchers have shown it is possible to find stem cells in adult women which spontaneously produced new eggs in the laboratory.

Further experiments on mice showed such eggs could be fertilised, according to a study in the journal Nature Medicine.

One British expert said the study re-wrote the rule book with “exciting possibilities” for improving fertility.

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The long-established theory is that women are born with all the eggs they will ever have. Lead researcher Dr Jonathan Tilly, from Massachusetts General Hospital, said this study, a follow up to one on mice in 2004, disproves that.

His team has reported finding and isolating the stem cells which go on to produce eggs in the ovaries of reproductive age women. It was done by searching for a protein, DDX4, which was unique to the surface of the stem cells. This allowed researchers to fish out the right cells.

When grown in the laboratory, the cells “spontaneously generated” immature eggs – or oocytes, which looked and acted like oocytes in the body.

The cells were “matured” when surrounded by living human ovarian tissue, which had been grafted inside mice.

There are tight legal and ethical restrictions on research on human eggs. The same experiments repeated using stem cells taken from mice showed the eggs could be fertilised with sperm and produced embryos.

Unprecedented

Dr Tilly said: “The primary objective of the current study was to prove that oocyte-producing stem cells do in fact exist in the ovaries of women during reproductive life, which we feel this study demonstrates very clearly.

“The discovery of oocyte precursor cells in adult human ovaries, coupled with the fact that these cells share the same characteristic features of their mouse counterparts that produce fully functional eggs, opens the door for development of unprecedented technologies to overcome infertility in women and perhaps even delay the timing of ovarian failure.”

He told Nature: “These cells, when maintained outside of the body, are more than happy to make cells on their own and if we can guide that process I think it opens up the chance that sometime in the future we might get to the point of having an unlimited source of human eggs.”

Dr Allan Pacey, a fertility expert at the University of Sheffield, said: “This is a nice study which shows quite convincingly that women’s ovaries contain stem cells that can divide and make eggs.  Not only does this re-write the rule book, it opens up a number of exciting possibilities for preserving the fertility of women undergoing treatment for cancer, or just maybe for women who are suffering infertility by extracting these cells and making her new eggs in the lab.”

Potential landmark

Stuart Lavery, a consultant gynaecologist and director of IVF at Hammersmith Hospital, said the findings were “extremely significant” and “a potentially landmark piece of research”.

He told the BBC: “If this research is confirmed it may overturn one of the great asymmetries of reproductive biology – that a woman’s reproductive pool of gametes may be renewable, just like a man’s.”

While cautioning that the cells were “some way” from any clinical use, Mr Lavery said they had potential, “particularly in young women facing sterilising treatment such as chemotherapy”.

Source: BBC News UK

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Diabetes Quadruples Birth Defects Risk, say Researchers

The study, published in the journal Diabetologia, analysed data from more than 400,000 pregnancies in the north-east of England. The risk of defects such as congenital heart disease and spina bifida were increased.

National guidelines already recommend having good control over blood sugar levels before trying to conceive.

Both Type 1 diabetes, which tends to appear in childhood, and Type 2 diabetes, largely as a result of diet, lead to problems controlling the amount of sugar in the blood.  This is known to cause problems in pregnancy, such as birth defects, miscarriage and the baby being overweight due to too much sugar.

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There is concern that rising levels of diabetes, particularly Type 2, could make the issue worse. Researchers at Newcastle University analysed data from 401,149 pregnancies between 1996 and 2008 – 1,677 women had diabetes.

The risk of birth defects went from 19 in every 1,000 births for women without pre-existing diabetes to 72 in every 1,000 births for women with diabetes. Their report said that sugar levels in the run-up to conception were the “most important” risk factor which could be controlled.

The lead researcher, Dr Ruth Bell from Newcastle University, told the BBC: “Many of these anomalies happen in the first four to six weeks.”

She said the number of pregnancies with poor sugar control were “more than we would like”. “It is a problem when the pregnancy is not intended or when people are not aware they need to talk to their doctors before pregnancy,” she said.

Guidelines from the National Institute of Health and Clinical Excellence say women should reduce their blood sugar levels to below 6.1% before trying to have a baby.

Diabetes Quadruples Birth Defects Risk, say Researchers

Dr Bell said: “The good news is that, with expert help before and during pregnancy, most women with diabetes will have a healthy baby. The risk of problems can be reduced by taking extra care to have the best possible glucose control before becoming pregnant.”

The charity Diabetes UK funded the study. Its director of research, Dr Iain Frame, said: “We need to get the message out to women with diabetes that if they are considering becoming pregnant, then they should tell their diabetes healthcare team, who will make sure they are aware of planning and what next steps they should be taking.It also highlights the importance of using contraception if you are a woman with diabetes who is sexually active but not planning to become pregnant.”

Source: BBC News UK

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Spoon Feeding makes Babies Fatter

Babies weaned on pureed food tend to end up fatter than infants whose first tastes are finger food, researchers believe.

Spoon feeding babies mashed up fruits and vegetables appears to give them a sweeter tooth, a Nottingham University team found after studying 155 children.

Infants who are instead allowed to feed themselves solids tend to favour more satiating carbohydrates like toast. This early self-regulation of what to eat keeps them slim, BMJ Open says.

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The researchers found spoon-fed babies were more often obese, although, overall, most of the youngsters in both groups were a healthy weight.

This weight difference remained even after the investigators accounted for other factors that might have influenced the findings, such the baby’s birth weight, how long they were breastfed for and whether their parents were rich or poor.

Dr Ellen Townsend, who led the research, believes baby-led weaning – where the child is offered a range of chunky foods to grab and self-feed – sets the stage for healthy eating in early childhood.

The ages of the 155 children who took part in the study ranged between 20 months and six years.

Questionnaires filled in by their parents revealed those children who were introduced early to finger foods developed a preference for carbohydrates like toasted pitta bread and pasta over sweeter foods like sugary fruit purees.

This was despite the fact that along with sweet foods, children in the spoon-fed group had also been offered carbohydrates, fruits and vegetables, proteins and whole meals such as lasagne more often than those in the baby-led weaning group.

Dr Townsend said: “It could be an age of introduction effect that we are seeing. Carbohydrates are ideal finger foods. But self-control of feeding may also be a factor. You are handing over control and letting the baby decide how much they want to eat.  With spoon feeding there is the temptation to get into them whatever is left in the bowl or the jar.”

She said longer-term studies were now needed to track the knock-on effect, if any, of weaning method on weight in adolescence and adulthood.

Rosie Dodds of the National Childbirth Trust said the findings suggested that it was safe to let babies feed themselves and choose their own foods when they were ready.

And Tam Fry, of the National Obesity Forum, said it was “quite logical” that babies might inherently know best when it came to which weaning foods to eat.

“It is important that they experience all five food groups and experiment with variety as much as possible. If half of it finishes on the floor, so be it – the value of experimentation in the early months of nutrition is incalculable, and babies won’t willingly starve themselves. If this also has the advantage of reducing unhealthy weight gain and avoiding obesity, it’s a win-win for mums.”

Dr. Colin Michie, Chair of the Nutrition Committee at the Royal College of Paediatrics and Child Health, said: “Although it has a relatively small sample size, this is an important study as it builds on the limited data currently available in this area.

“The findings are particularly valuable and interesting as they suggest that altering weaning patterns can have a direct impact on a child’s food selection when they get older.  In other words, adjusting weaning could well help tackle the high rates of obesity currently found in the UK. This could be a key element in the fight to prevent overweight children becoming obese adults.”

But baby-led weaning may not stop the child becoming a fussy eater though – a similar number of youngsters in both groups were deemed by their parents to be “picky” about the foods they would eat.

Source: BBC News UK

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