Medical News Snippets

Some snippets from last week’s medical news:

Traditional crib bumpers should be banned: US data has shown bumper suffocation cases to be on the rise (48 cases from 1985-2012, 90% were ≤7 months). I know, low numbers compared with car accidents but no-one wants to take on the issue of infant death. The risk MAY be reduced with newer types of bumpers (eg. mesh and vertical designs).

Waist-to-hip ratio (an indicator of central obesity) is more accurate than body mass index (measurement using weight and height only) in determining cardiovascular risk. BMI use has always been limited in certain populations (eg. Very athletic/ muscular) and it has been found that people with central obesity (WHR ≥0.9 in men, ≥0.85 in women) are more likely to die of cardiovascular causes (see the case of Xareto) EVEN if they are of normal weight. Apple shape no good la.

For all the new mums (parents): sleep loss from frequent awakening is more detrimental to mood than sleep loss from restricted sleep. So you’re worse off if you’re woken several times by a baby than if you go to bed late – even if you have the same total amount of sleep. Yar, no kidding… 🙁

Women with gestational diabetes mellitus (GDM) who breastfeed (BF) have half the risk for developing Type II DM later on (higher intensity and longer duration of BF correlates with lower DM risk).

Late (>6 month) introduction of gluten to infants may be associated with increased risk of celiac disease (a risk that even BF doesn’t help ameliorate). It is therefore recommended that gluten be introduced to infant diets at 4-6 months of age.

OG specialists recommend daily physical activity during uncomplicated pregnancies. Yawn… Seriously they are still debating this? Labour and delivery are nature’s ultimate workout… You want to be fit for it, trust me. If you have certain medical conditions or contraindications then of course that’s a different matter.

Ultrasound near term overestimates foetal size in GDM: super interesting study because it seems every woman you talk to these days has been recommended by her doctor to be induced or delivered early “because the baby is too big”. It seems ultrasound close to term can be out by >500g.

Hanging on to that extra weight between pregnancies? Hmmm, not so good… Interpregnancy weight gain is associated with future adverse birth outcomes. A study of over 500,000 women found that (compared with women whose weight remained stable), a gain of 2-3 BMI units was associated with an increased risk of stillbirth of 55%. This is of course aside from all the other problems associated with being overweight/ obese.

REFERENCES
Thach BT, Rutherford GW Jr, Harris K. Deaths and injuries attributed to infant crib bumper pads. J Pediatr. 2007 Sep;151(3):271-4, 274.e1-3. Epub 2007 Jul 25.
Poirier P. The Many Paradoxes of Our Modern World: Is There Really an Obesity Paradox or Is It Only a Matter of Adiposity Assessment? Ann Intern Med. 2015 Nov 10. doi: 10.7326/M15-2435. [Epub ahead of print]
Sahakyan KR et al. Normal-weight central obesity: Implications for total and cardiovascular mortality. Ann Intern Med 2015 Nov 10; [e-pub].
Finan PH, Quartana PJ, Smith MT. The Effects of Sleep Continuity Disruption on Positive Mood and Sleep Architecture in Healthy Adults. Sleep. 2015 Jun 11. pii: sp-00003-15. [Epub ahead of print]
Gunderson EP, Hurston SR, Ning X, Lo JC, Crites Y, Walton D, Dewey KG, Azevedo RA, Young S, Fox G, Elmasian CC, Salvador N, Lum M, Sternfeld B, Quesenberry CP Jr; Study of Women, Infant Feeding and Type 2 Diabetes After GDM Pregnancy Investigators. Lactation and Progression to Type 2 Diabetes Mellitus After Gestational Diabetes Mellitus: A Prospective Cohort Study. Ann Intern Med. 2015 Nov 24:889-898. doi: 10.7326/M15-0807. [Epub ahead of print]
Pinto-Sanchez MI, Verdu EF, Liu E, et al. Gluten Introduction to Infant Feeding and Risk of Celiac Disease: Systematic Review and Meta-Analysis. J Pediatr. 2015 Oct 20. pii: S0022-3476(15)01045-8. doi: 10.1016/j.jpeds.2015.09.032.
Scifres CM, Feghali M, Dumont T, et al. Large-for-Gestational-Age Ultrasound Diagnosis and Risk for Cesarean Delivery in Women With Gestational Diabetes Mellitus. Obstet Gynecol. 2015 Nov;126(5):978-86. doi: 10.1097/AOG.0000000000001097.(Original) PMID: 26444129
Cnattingius S, Villamor E. Weight change between successive pregnancies and risks of stillbirth and infant mortality: a nationwide cohort study. The Lancet 2015 Dec 2. http://dx.doi.org/10.1016/S0140-6736(15)00990-3

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