Doctors Test Bacterial Smear After C-sections To Bolster Babies' Health
New Blood Tests Promise to Better Predict Early Labor
Advanced Prenatal Testing Means More Gut-Wrenching Decisions Over Abortion
Popular Fertility Test Doesn't Work, Study Says
Pregnant Women Should Still Get The Flu Vaccine, Doctors Advise
Xanax Or Zoloft For Moms-To-Be: A New Study Assesses Safety
'Electronic Tattoos' Could Monitor Pregnant Moms at Home
Bay Area Scientists Develop Mini Human Heart Chamber in a Dish
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When on deadline she fuels herself almost exclusively on chocolate chips.\r\n\r\n ","avatar":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g","twitter":"lesleywmcclurg","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"news","roles":["editor"]},{"site":"futureofyou","roles":["editor"]},{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["editor"]},{"site":"forum","roles":["author"]}],"headData":{"title":"Lesley McClurg | KQED","description":"KQED Health Correspondent","ogImgSrc":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/3fb78e873af3312f34d0bc1d60a07c7f?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lesleymcclurg"},"aahmed":{"type":"authors","id":"11428","meta":{"index":"authors_1591205172","id":"11428","found":true},"name":"Amel Ahmed","firstName":"Amel","lastName":"Ahmed","slug":"aahmed","email":"aahmed@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":"Amel Ahmed is a reporter for KQED. Prior to joining KQED, Amel worked at Al Jazeera America, Al Jazeera English, Democracy Now! and Punched Productions. She also helped produce \u003cem>Changing Face of Harlem\u003c/em>, a documentary that tracked gentrification in Harlem over a period of ten years. She is a 2013 graduate of Brooklyn Law School and is currently researching war on terror prosecutions for an upcoming book.","avatar":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g","twitter":"amelscript","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"futureofyou","roles":["editor"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Amel Ahmed | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/c8b48ebc98e770640f3013c470d23f3e?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/aahmed"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"futureofyou_445306":{"type":"posts","id":"futureofyou_445306","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445306","score":null,"sort":[1540921365000]},"guestAuthors":[],"slug":"doctors-test-bacterial-smear-after-c-sections-to-bolster-babies-health","title":"Doctors Test Bacterial Smear After C-sections To Bolster Babies' Health","publishDate":1540921365,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Danielle Vukadinovich is sitting up in a hospital bed at the Inova Women's Hospital in Falls Church, Va., waiting to give birth.\u003c/p>\n\u003cp>\"I feel good, I'm excited!\" says Vukadinovich, 35, of Annandale, Va., \"Nervous, but good!\"[contextly_sidebar id=\"FEjJfJVXw64VNWTIkBjmTrT87lKdBgJO\"]\u003c/p>\n\u003cp>Vukadinovich is getting a \u003ca href=\"https://medlineplus.gov/cesareansection.html\" target=\"_blank\" rel=\"noopener\">cesarean section\u003c/a> today. It's the second time for her — she underwent the surgical procedure 19 months ago when her twins were born.\u003c/p>\n\u003cp>This time Danielle wants to try something different, something that might sound strange. As soon as her daughter is born, a doctor will wipe bacteria fluid from Danielle's birth canal all over her baby's body.\u003c/p>\n\u003cp>\"I haven't told many people about this yet,\" Vukadinovich says, laughing. \"I understand why people would be like, 'Oh my gosh. That's so weird.' But I don't think it's yucky. It's normal. It's natural really.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The procedure, known as \"\u003ca href=\"https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/vaginal-seeding/faq-20380881\" target=\"_blank\" rel=\"noopener\">vaginal seeding\u003c/a>,\" is designed to help babies develop healthy microbiomes — the collection of friendly bacteria that inhabit every person's body. Some people call it a \"bacterial baptism.\"\u003c/p>\n\u003cp>\"It's a little bit like that baby's first dunk,\" says \u003ca href=\"https://www.inova.org/indirectory/clinicaltrials.aspx?design=true&dirId=1&LoadCategory=ITMI&LoadSubCategory=Microbiome&memberID=280\" target=\"_blank\" rel=\"noopener\">Shira Levy\u003c/a>, the microbiome research manager at the Inova hospital. \"That's their first religious experience. You know, they get the water and that changes their spirituality.\u003c/p>\n\u003cp>\"In this case, they get the bacteria and that changes their microbiome,\" Levy says. \"This is their first microbiome experience.\"\u003c/p>\n\u003cp>The procedure was developed in response to the sharp rise in C-section births in recent years. That increase has been accompanied by \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/30/444746094/missing-microbes-provide-clues-about-asthma-risk\" target=\"_blank\" rel=\"noopener\">more cases of asthma\u003c/a>, allergies, eczema, obesity, and other diseases.\u003c/p>\n\u003cp>The theory is that the rise in these diseases might be happening, in part, because babies aren't getting exposed to their mother's microbes the way they would if they were passing naturally through the birth canal.[contextly_sidebar id=\"0AllfLEduBOKAavkhBROexZnBFbtKljt\"]\u003c/p>\n\u003cp>\"We think that one of the reasons that babies born by C-section are at increased risk for these diseases is because they don't receive that first beneficial exposure to their mother's vaginal microbiome,\" says \u003ca href=\"https://www.inova.org/Physician_Directory/Suchitra-K-Hourigan-MD/824530\" target=\"_blank\" rel=\"noopener\">Suchitra Hourigan\u003c/a>, a pediatric gastroenterologist at Inova.\u003c/p>\n\u003cp>One very small study \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/01/464905786/researchers-test-microbe-wipe-to-promote-babies-health-after-c-sections\" target=\"_blank\" rel=\"noopener\">indicated \u003c/a>that swabbing C-section babies with their mother's microbes immediately after birth could make their microbiomes develop more like those of babies born vaginally.\u003c/p>\n\u003cp>But the appeal of vaginal seeding has outpaced evidence that it is safe and effective.\u003c/p>\n\u003cp>Some couples have started trying vaginal seeding on their own. Vukadinovich jokes that she considered doing it herself. After all, she says, she's a nurse and her husband is a high school biology teacher.\u003c/p>\n\u003cp>\"I even told my mom: 'Nobody has to know. My husband would help me out,' \" she says, laughing. \"But I try not to take unnecessary risks.\"\u003c/p>\n\u003cp>Vukadinovich knows the procedure could be risky. Babies could be inadvertently exposed to disease-causing microbes, such as herpes virus or streptococcus bacteria.\u003c/p>\n\u003cp>In fact, medical groups such as the American College of Obstetrics and Gynecology \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vaginal-Seeding\" target=\"_blank\" rel=\"noopener\">warn\u003c/a> women against doing this. \"While there are data to suggest that there may be some scientific plausibility to the concept, it is not without significant risks,\" says \u003ca href=\"http://newsroom.ucla.edu/experts/preview/578561302cfac209100154a4/\" target=\"_blank\" rel=\"noopener\">Neil Silverman\u003c/a>, a clinical professor of obstetrics and gynecology at the UCLA School of Medicine, who represents ACOG. The group notes that mothers also transfer microbes to their newborns through skin-to-skin contact and breastfeeding.\u003c/p>\n\u003cp>So Vukadinovich was thrilled when she found out she could be part of the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03298334?term=vaginal+seeding&rank=1\" target=\"_blank\" rel=\"noopener\">study\u003c/a> the Food and Drug Administration is allowing to rigorously test whether the procedure is safe and helps improve babies' health.[contextly_sidebar id=\"kMHzgUs0dutTuVHV7G0EJpefrLt2hB8h\"]\u003c/p>\n\u003cp>\"Who knows what's going to happen with the results? But if it does show something positive, I just think that would be great for kids and parents,\" she says.\u003c/p>\n\u003cp>Hourigan, who's helping lead the study, agrees. \"Just to be able to reduce one risk factor for obesity, especially when there are such high [C-section rates] in the U.S., would be huge,\" she says.\u003c/p>\n\u003cp>In the study, half of the babies will get swabbed with their mother's microbes; half will get swabbed with a sterile solution. All of the mothers will be carefully screened for dangerous infections.\u003c/p>\n\u003cp>All of the babies will then be followed for three years to see if they become obese or develop other health problems. A \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03567707?term=vaginal+seeding&rank=2\" target=\"_blank\" rel=\"noopener\">similar study\u003c/a> is starting at the Icahn School of Medicine at Mount Sinai in New York City.\u003c/p>\n\u003cp>Vukadinovich agreed to let an NPR reporter and photographer observe her baby's birth and the swabbing. It's the first time journalists have been allowed to watch a baby go through the study.\u003c/p>\n\u003cp>\u003cstrong>Evelyn Marie is Born\u003c/strong>\u003c/p>\n\u003cp>As the nurses wheel Vukadinovich into the operating room, Hourigan, Levy and Dr. Varsha Deopujari follow. Deopujari, the study's clinical manager, will do the actual swabbing.\u003c/p>\n\u003cp>Inside the OR, everyone quickly takes their places. As the surgeon starts, Hourigan explains what's happening. It goes very fast.\u003c/p>\n\u003cp>\"An incision is being made into mom, and they are getting ready to take out the baby,\" Hourigan says. \"They can see the head. And the head is now coming out of the C-section incision. Baby's head is out.\"\u003c/p>\n\u003cp>In less than a minute after the surgery starts, the baby girl is completely out. A nurse rushes the newborn to a nearby table to clear her breathing. After the baby is breathing smoothly, Deopujari starts swabbing with a gauze pad.\u003c/p>\n\u003cp>First, she swabs the baby's mouth, cheeks and face. After turning the gauze over to expose more bacteria, Deopujari wipes the baby's hands and arms. Next, she wipes down her chest, goes over her abdomen, up the other arm and then over her back.[contextly_sidebar id=\"umm131VoK2OKqBWygztDrKkMjOgsaGeH\"]\u003c/p>\n\u003cp>\"And the swabbing is now over,\" Hourigan says.\u003c/p>\n\u003cp>Deopujari hands the baby back to a nurse. Hourigan and her team quickly head out of the OR.\u003c/p>\n\u003cp>\"That went perfectly,\" she says. \"Baby came out and was crying. We waited until baby was stable, and the swabbing went just as planned.\"\u003c/p>\n\u003cp>Hourigan and her colleagues will swab 50 babies to make sure their procedure is safe. If it is, they plan to expand the study to 800 babies, who would randomly receive either the bacterial swab or a placebo, throughout the Inova hospital system.\u003c/p>\n\u003cp>The results could prove important. \"We need more data and we need better data,\" says Silverman, of ACOG. \"If it shows that there is a clear benefit, then this process can be re-evaluated.\"\u003c/p>\n\u003cp>The next morning, Vukadinovich, her husband, Nick, 41, and their new daughter are together in a hospital room.\u003c/p>\n\u003cp>\"I'm good — feeling good today,\" she says, cradling her baby.\u003c/p>\n\u003cp>The couple doesn't know if their new daughter, who they would later name Evelyn Marie, was exposed to her mother's microbes or a sterile placebo solution. But they have their fingers crossed she was swabbed with bacteria.\u003c/p>\n\u003cp>\"I really hope that she was,\" Vukadinovich says. \"If there's a decreased chance of her having any health issues, that would be awesome.\"\u003c/p>\n\u003cp>Her husband, Nick, agrees.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We're not terribly religious so we won't baptize with water — holy water,\" Nick says. \"But since we're scientists, we like the idea of a bacterial baptism instead of a holy baptism — because now she's been initiated with bacteria, friendly bacteria, that should protect her down the road.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Doctors+Test+Bacterial+Smear+After+Cesarean+Sections+To+Bolster+Babies%27+Microbiomes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"After a C-section, does swabbing a baby with the mother's microbes reduce the risk of obesity and other health problems later in life? An ambitious study to help answer the question is underway.","status":"publish","parent":0,"modified":1540921365,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":42,"wordCount":1252},"headData":{"title":"Doctors Test Bacterial Smear After C-sections To Bolster Babies' Health | KQED","description":"After a C-section, does swabbing a baby with the mother's microbes reduce the risk of obesity and other health problems later in life? An ambitious study to help answer the question is underway.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Doctors Test Bacterial Smear After C-sections To Bolster Babies' Health","datePublished":"2018-10-30T17:42:45.000Z","dateModified":"2018-10-30T17:42:45.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"445306 https://ww2.kqed.org/futureofyou/?p=445306","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/30/doctors-test-bacterial-smear-after-c-sections-to-bolster-babies-health/","disqusTitle":"Doctors Test Bacterial Smear After C-sections To Bolster Babies' Health","source":"DIY Health","nprByline":"Rob Stein, NPR","nprImageAgency":"Mary Mathis/NPR","nprStoryId":"658254175","nprApiLink":"http://api.npr.org/query?id=658254175&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/10/30/658254175/doctors-test-bacterial-smear-after-cesarean-sections-to-bolster-babies-microbiom?ft=nprml&f=658254175","nprRetrievedStory":"1","nprPubDate":"Tue, 30 Oct 2018 09:58:00 -0400","nprStoryDate":"Tue, 30 Oct 2018 05:03:00 -0400","nprLastModifiedDate":"Tue, 30 Oct 2018 12:45:06 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/10/20181030_me_doctors_test_bacterial_smear_after_cesarean_sections_to_bolster_babies_microbiomes.mp3?orgId=1&topicId=1128&d=421&p=3&story=658254175&ft=nprml&f=658254175","nprAudioM3u":"http://api.npr.org/m3u/1662009687-72e5e0.m3u?orgId=1&topicId=1128&d=421&p=3&story=658254175&ft=nprml&f=658254175","audioTrackLength":422,"path":"/futureofyou/445306/doctors-test-bacterial-smear-after-c-sections-to-bolster-babies-health","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2018/10/20181030_me_doctors_test_bacterial_smear_after_cesarean_sections_to_bolster_babies_microbiomes.mp3?orgId=1&topicId=1128&d=421&p=3&story=658254175&ft=nprml&f=658254175","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Danielle Vukadinovich is sitting up in a hospital bed at the Inova Women's Hospital in Falls Church, Va., waiting to give birth.\u003c/p>\n\u003cp>\"I feel good, I'm excited!\" says Vukadinovich, 35, of Annandale, Va., \"Nervous, but good!\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Vukadinovich is getting a \u003ca href=\"https://medlineplus.gov/cesareansection.html\" target=\"_blank\" rel=\"noopener\">cesarean section\u003c/a> today. It's the second time for her — she underwent the surgical procedure 19 months ago when her twins were born.\u003c/p>\n\u003cp>This time Danielle wants to try something different, something that might sound strange. As soon as her daughter is born, a doctor will wipe bacteria fluid from Danielle's birth canal all over her baby's body.\u003c/p>\n\u003cp>\"I haven't told many people about this yet,\" Vukadinovich says, laughing. \"I understand why people would be like, 'Oh my gosh. That's so weird.' But I don't think it's yucky. It's normal. It's natural really.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The procedure, known as \"\u003ca href=\"https://www.mayoclinic.org/healthy-lifestyle/infant-and-toddler-health/expert-answers/vaginal-seeding/faq-20380881\" target=\"_blank\" rel=\"noopener\">vaginal seeding\u003c/a>,\" is designed to help babies develop healthy microbiomes — the collection of friendly bacteria that inhabit every person's body. Some people call it a \"bacterial baptism.\"\u003c/p>\n\u003cp>\"It's a little bit like that baby's first dunk,\" says \u003ca href=\"https://www.inova.org/indirectory/clinicaltrials.aspx?design=true&dirId=1&LoadCategory=ITMI&LoadSubCategory=Microbiome&memberID=280\" target=\"_blank\" rel=\"noopener\">Shira Levy\u003c/a>, the microbiome research manager at the Inova hospital. \"That's their first religious experience. You know, they get the water and that changes their spirituality.\u003c/p>\n\u003cp>\"In this case, they get the bacteria and that changes their microbiome,\" Levy says. \"This is their first microbiome experience.\"\u003c/p>\n\u003cp>The procedure was developed in response to the sharp rise in C-section births in recent years. That increase has been accompanied by \u003ca href=\"https://www.npr.org/sections/health-shots/2015/09/30/444746094/missing-microbes-provide-clues-about-asthma-risk\" target=\"_blank\" rel=\"noopener\">more cases of asthma\u003c/a>, allergies, eczema, obesity, and other diseases.\u003c/p>\n\u003cp>The theory is that the rise in these diseases might be happening, in part, because babies aren't getting exposed to their mother's microbes the way they would if they were passing naturally through the birth canal.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"We think that one of the reasons that babies born by C-section are at increased risk for these diseases is because they don't receive that first beneficial exposure to their mother's vaginal microbiome,\" says \u003ca href=\"https://www.inova.org/Physician_Directory/Suchitra-K-Hourigan-MD/824530\" target=\"_blank\" rel=\"noopener\">Suchitra Hourigan\u003c/a>, a pediatric gastroenterologist at Inova.\u003c/p>\n\u003cp>One very small study \u003ca href=\"https://www.npr.org/sections/health-shots/2016/02/01/464905786/researchers-test-microbe-wipe-to-promote-babies-health-after-c-sections\" target=\"_blank\" rel=\"noopener\">indicated \u003c/a>that swabbing C-section babies with their mother's microbes immediately after birth could make their microbiomes develop more like those of babies born vaginally.\u003c/p>\n\u003cp>But the appeal of vaginal seeding has outpaced evidence that it is safe and effective.\u003c/p>\n\u003cp>Some couples have started trying vaginal seeding on their own. Vukadinovich jokes that she considered doing it herself. After all, she says, she's a nurse and her husband is a high school biology teacher.\u003c/p>\n\u003cp>\"I even told my mom: 'Nobody has to know. My husband would help me out,' \" she says, laughing. \"But I try not to take unnecessary risks.\"\u003c/p>\n\u003cp>Vukadinovich knows the procedure could be risky. Babies could be inadvertently exposed to disease-causing microbes, such as herpes virus or streptococcus bacteria.\u003c/p>\n\u003cp>In fact, medical groups such as the American College of Obstetrics and Gynecology \u003ca href=\"https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Vaginal-Seeding\" target=\"_blank\" rel=\"noopener\">warn\u003c/a> women against doing this. \"While there are data to suggest that there may be some scientific plausibility to the concept, it is not without significant risks,\" says \u003ca href=\"http://newsroom.ucla.edu/experts/preview/578561302cfac209100154a4/\" target=\"_blank\" rel=\"noopener\">Neil Silverman\u003c/a>, a clinical professor of obstetrics and gynecology at the UCLA School of Medicine, who represents ACOG. The group notes that mothers also transfer microbes to their newborns through skin-to-skin contact and breastfeeding.\u003c/p>\n\u003cp>So Vukadinovich was thrilled when she found out she could be part of the first \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03298334?term=vaginal+seeding&rank=1\" target=\"_blank\" rel=\"noopener\">study\u003c/a> the Food and Drug Administration is allowing to rigorously test whether the procedure is safe and helps improve babies' health.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"Who knows what's going to happen with the results? But if it does show something positive, I just think that would be great for kids and parents,\" she says.\u003c/p>\n\u003cp>Hourigan, who's helping lead the study, agrees. \"Just to be able to reduce one risk factor for obesity, especially when there are such high [C-section rates] in the U.S., would be huge,\" she says.\u003c/p>\n\u003cp>In the study, half of the babies will get swabbed with their mother's microbes; half will get swabbed with a sterile solution. All of the mothers will be carefully screened for dangerous infections.\u003c/p>\n\u003cp>All of the babies will then be followed for three years to see if they become obese or develop other health problems. A \u003ca href=\"https://clinicaltrials.gov/ct2/show/NCT03567707?term=vaginal+seeding&rank=2\" target=\"_blank\" rel=\"noopener\">similar study\u003c/a> is starting at the Icahn School of Medicine at Mount Sinai in New York City.\u003c/p>\n\u003cp>Vukadinovich agreed to let an NPR reporter and photographer observe her baby's birth and the swabbing. It's the first time journalists have been allowed to watch a baby go through the study.\u003c/p>\n\u003cp>\u003cstrong>Evelyn Marie is Born\u003c/strong>\u003c/p>\n\u003cp>As the nurses wheel Vukadinovich into the operating room, Hourigan, Levy and Dr. Varsha Deopujari follow. Deopujari, the study's clinical manager, will do the actual swabbing.\u003c/p>\n\u003cp>Inside the OR, everyone quickly takes their places. As the surgeon starts, Hourigan explains what's happening. It goes very fast.\u003c/p>\n\u003cp>\"An incision is being made into mom, and they are getting ready to take out the baby,\" Hourigan says. \"They can see the head. And the head is now coming out of the C-section incision. Baby's head is out.\"\u003c/p>\n\u003cp>In less than a minute after the surgery starts, the baby girl is completely out. A nurse rushes the newborn to a nearby table to clear her breathing. After the baby is breathing smoothly, Deopujari starts swabbing with a gauze pad.\u003c/p>\n\u003cp>First, she swabs the baby's mouth, cheeks and face. After turning the gauze over to expose more bacteria, Deopujari wipes the baby's hands and arms. Next, she wipes down her chest, goes over her abdomen, up the other arm and then over her back.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"And the swabbing is now over,\" Hourigan says.\u003c/p>\n\u003cp>Deopujari hands the baby back to a nurse. Hourigan and her team quickly head out of the OR.\u003c/p>\n\u003cp>\"That went perfectly,\" she says. \"Baby came out and was crying. We waited until baby was stable, and the swabbing went just as planned.\"\u003c/p>\n\u003cp>Hourigan and her colleagues will swab 50 babies to make sure their procedure is safe. If it is, they plan to expand the study to 800 babies, who would randomly receive either the bacterial swab or a placebo, throughout the Inova hospital system.\u003c/p>\n\u003cp>The results could prove important. \"We need more data and we need better data,\" says Silverman, of ACOG. \"If it shows that there is a clear benefit, then this process can be re-evaluated.\"\u003c/p>\n\u003cp>The next morning, Vukadinovich, her husband, Nick, 41, and their new daughter are together in a hospital room.\u003c/p>\n\u003cp>\"I'm good — feeling good today,\" she says, cradling her baby.\u003c/p>\n\u003cp>The couple doesn't know if their new daughter, who they would later name Evelyn Marie, was exposed to her mother's microbes or a sterile placebo solution. But they have their fingers crossed she was swabbed with bacteria.\u003c/p>\n\u003cp>\"I really hope that she was,\" Vukadinovich says. \"If there's a decreased chance of her having any health issues, that would be awesome.\"\u003c/p>\n\u003cp>Her husband, Nick, agrees.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We're not terribly religious so we won't baptize with water — holy water,\" Nick says. \"But since we're scientists, we like the idea of a bacterial baptism instead of a holy baptism — because now she's been initiated with bacteria, friendly bacteria, that should protect her down the road.\"\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Doctors+Test+Bacterial+Smear+After+Cesarean+Sections+To+Bolster+Babies%27+Microbiomes&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445306/doctors-test-bacterial-smear-after-c-sections-to-bolster-babies-health","authors":["byline_futureofyou_445306"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_631","futureofyou_1635","futureofyou_61","futureofyou_68","futureofyou_520"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_445307","label":"source_futureofyou_445306"},"futureofyou_442039":{"type":"posts","id":"futureofyou_442039","meta":{"index":"posts_1591205157","site":"futureofyou","id":"442039","score":null,"sort":[1528822825000]},"guestAuthors":[],"slug":"new-blood-tests-promise-to-better-predict-early-labor","title":"New Blood Tests Promise to Better Predict Early Labor","publishDate":1528822825,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Two new blood tests promise pregnant women an easier, more affordable way of predicting their risk for an premature delivery. The blood tests, developed by\u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\"> Stanford University School of Medicine\u003c/a> and \u003ca href=\"https://www.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">UC San Francisco\u003c/a>, look for specific biomarkers in the mother's bloodstream.[contextly_sidebar id=\"A9EcAExSSebnSiay0So2km8e4YnmN7OM\"]\u003c/p>\n\u003cp>Preterm delivery, which occurs when a baby is born before the 37th week of pregnancy, is the leading cause of death for children under 5 in the United States.\u003c/p>\n\u003cp>The \u003ca href=\"http://science.sciencemag.org/content/360/6393/1133\" target=\"_blank\" rel=\"noopener\">Stanford-led study\u003c/a>, predicts the risk of preterm birth using fetal RNA found in the mother's blood, while the \u003ca href=\"https://www.nature.com/articles/s41372-018-0112-0\" target=\"_blank\" rel=\"noopener\">UCSF study\u003c/a> focuses on inflammation markers.\u003c/p>\n\u003cp>There is currently one blood test on the market that screens for preterm risk, but it comes with serious limitations, according to \u003ca href=\"https://profiles.ucsf.edu/laura.jelliffe-pawlowski\" target=\"_blank\" rel=\"noopener\">Laura Jelliffe-Pawlowski\u003c/a>, co-author of the UCSF study and director of the \u003ca href=\"https://pretermbirth.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">UCSF California Preterm Birth Initiative\u003c/a>. The costly test screens only for spontaneous preterm births. About three quarters of preterm births occur spontaneously while 25 percent are induced due to medical complications.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We want to make sure that we're developing something that has the potential to help all women, including those most in need.’\u003ccite>Laura Jelliffe-Pawlowski, UCSF \u003c/cite>\u003c/aside>\n\u003cp>But for practitioners like \u003ca href=\"https://www.ucsfhealth.org/juan.gonzalez-velez\" target=\"_blank\" rel=\"noopener\">Dr. Juan Gonzalez\u003c/a>, a perinatologist at UCSF Medical Center, knowing whether a pregnancy is high-risk is not all that helpful without being able to adequately treat the problem.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"A patient can have a positive result but we need to know which intervention is the right intervention. This is a great finding but now we need those next steps, which are studies that focus on interventions. That's the part we don’t really know.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.mayoclinic.org/biographies/butler-tobah-yvonne-s-m-d/bio-20113896\" target=\"_blank\" rel=\"noopener\">Dr. Yvonne Butler Tobah\u003c/a>, a Mayo obstetrician, called the developments \"groundbreaking\" but warned that further research is required before it can be instituted clinically.\u003c/p>\n\u003cp>\u003cstrong>Causes of Preterm Birth\u003c/strong>\u003c/p>\n\u003cp>The causes of pre-term birth are not well understood, but doctors look for certain traits associated with the risk, according to\u003c/p>\n\u003cp>\"So we know things like hypertension and diabetes are associated with preterm birth,\" says Jelliffe-Pawlowski. \"And also the kinds of things that the test picks up, like inflammation, is associated with preterm birth.\"[contextly_sidebar id=\"CpQ3Oc4MfPMthrebKJEmSP9wVqLfobiI\"]\u003c/p>\n\u003cp>The UCSF study also looked at income and age of the pregnant women, two factors that exert an independent influence on bodily inflammation and placenta function, according to Jelliffe-Pawlowski. Mothers over the age of 34 are found to be at higher risk of inflammation levels.\u003c/p>\n\u003cp>An underlying infection, exposure to environmental toxins, stress, or chronic ailments like diabetes, can all trigger an inflammatory response in pregnant women, a condition that has potential to induce an early pregnancy.\u003c/p>\n\u003cp>A subset of women who test positive for preterm risk have a severe pregnancy complication called preeclampsia. The potentially fatal condition is characterized by high blood pressure and organ failure in the mother.\u003c/p>\n\u003cp>\u003cb>Treatments are Limited\u003c/b>\u003c/p>\n\u003cp>Current medical treatments are typically limited to cases of preeclampsia, and involve taking aspirin, which Jelliffe-Pawlowski says reduces the occurrence of preeclampsia by up to 30 percent.\u003c/p>\n\u003cp>For women with a prior history of preterm delivery, there is a progesterone supplement that is currently offered to decrease the risk, according to Tobah.\u003c/p>\n\u003cp>\"Prior preterm birth confers about a two fold increased risk,\" she said.\u003c/p>\n\u003cp>But outside of this limited category of high-risk pregnancies, there isn't much doctors can recommend in the way of decreasing preterm risk -- outside of bed rest, according to Gonzalez.\u003c/p>\n\u003cp>And preeclampsia comprises just 15 percent of all preterm births, making preventative care for the great majority of preterm cases all the more urgent, says Gonzalez.\u003c/p>\n\u003cp>\"Before doctors start running these tests, we really need to know what are we going to tell these women besides, 'You’re at risk,'\" he says.[contextly_sidebar id=\"FTcRs64SRm7xpizZAGK2uc0iQv1HNynr\"]\u003c/p>\n\u003cp>But for the researchers involved in both studies, affordability and accessibility played an important role in the tests' development.\u003c/p>\n\u003cp>\"While the current available treatments are not great, I do think they have some effect,\" says co-author \u003ca href=\"https://profiles.stanford.edu/mads-melbye\" target=\"_blank\" rel=\"noopener\">Mads Melbye\u003c/a>, a professor in medical epidemiology at the University of Copenhagen, Denmark. \"For instance, if you know a woman is likely to deliver a preterm baby, you would likely refer her to a specialized hospital. And certainly the knowledge alone is important.\"\u003c/p>\n\u003cp>For Jelliffe-Pawlowski, helping pregnant women in disadvantaged communities was a huge motivator for developing the test.\u003c/p>\n\u003cp>\"What we hear from women in the community, particularly black and Latina women, is what's really important to them, is knowing their risk,\" says Jelliffe-Pawlowski. \"It's not necessary that we fix it, but there's an opportunity to communicate risk with women so they can be taken care of appropriately.\"\u003c/p>\n\u003cp>And Melbye says accurate tests are important, since inaccurate estimates can lead to unnecessary treatments such as the induction of labor or Cesarean sections.\u003c/p>\n\u003cp>\u003cstrong>Measuring Risk Through RNA\u003c/strong>\u003c/p>\n\u003cp>The Stanford-led study, published last week in the journal Science, measured cell-free fetal RNA in the mothers' bloodstream to determine the due date and preterm risk.\u003c/p>\n\u003cp>The researchers compared the blood results of women who had healthy pregnancies with those found to be at high risk for preterm delivery. They accurately predicted six of eight preterm cases and wrongly classified only one of 26 full-term cases.\u003c/p>\n\u003cp>But the Stanford test is a pilot study based on a limited number of women.[contextly_sidebar id=\"RsEfYdBoZW1b667qNhE5ZxykfR7kWICL\"]\u003c/p>\n\u003cp>\"The next step will be to apply the findings to large clinical trials,\" says Melbye. \"The study is just the first in a series of studies that allows us to look at the different outcomes of pregnancy. The hope is that it will lead to healthier and safer pregnancies.\"\u003c/p>\n\u003cp>\u003cstrong>Measuring Risk Through Inflammation\u003c/strong>\u003c/p>\n\u003cp>The UCSF test focused on 63 biomarkers in the mother's bloodstream related to inflammation and placenta function. From there, researchers narrowed the test down to 25 biomarkers that together help to predict the chances of an early pregnancy.\u003c/p>\n\u003cp>The study, published in the May issue of \u003ca href=\"https://www.nature.com/articles/s41372-018-0112-0\">\u003ci>Journal of Perinatology\u003c/i>\u003c/a>, is more than 80 percent accurate in predicting preterm births in women who are between 15 and 20 weeks pregnant.\u003c/p>\n\u003cp>In cases of high risk pregnancies, the test was nearly 90 percent accurate.[contextly_sidebar id=\"7E5bGDPvRlmxjV4ypvKH5ngagVo4ise4\"]\u003c/p>\n\u003cp>The UCSF test, which took five years to develop, is based on ten years of research by Jelliffe-Pawlowski's team. Researchers took blood samples from 400 women during their second trimester.\u003c/p>\n\u003cp>Researchers hope their blood tests will lead to better preventative treatments for women found to be at high risk of preterm birth.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We want to make sure that we're developing something that has the potential to help all women, including those most in need,\" says Jelliffe-Pawlowski.\u003c/p>\n\n","blocks":[],"excerpt":"There is currently one blood test on the market that screens for preterm risk, but it comes with serious limitations. Now, two new tests hold the promise that pregnant women will have an easier, more affordable way.","status":"publish","parent":0,"modified":1528505692,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":39,"wordCount":1144},"headData":{"title":"New Blood Tests Promise to Better Predict Early Labor | KQED","description":"There is currently one blood test on the market that screens for preterm risk, but it comes with serious limitations. Now, two new tests hold the promise that pregnant women will have an easier, more affordable way.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Blood Tests Promise to Better Predict Early Labor","datePublished":"2018-06-12T17:00:25.000Z","dateModified":"2018-06-09T00:54:52.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"442039 https://ww2.kqed.org/futureofyou/?p=442039","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/06/12/new-blood-tests-promise-to-better-predict-early-labor/","disqusTitle":"New Blood Tests Promise to Better Predict Early Labor","path":"/futureofyou/442039/new-blood-tests-promise-to-better-predict-early-labor","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Two new blood tests promise pregnant women an easier, more affordable way of predicting their risk for an premature delivery. The blood tests, developed by\u003ca href=\"http://med.stanford.edu/\" target=\"_blank\" rel=\"noopener\"> Stanford University School of Medicine\u003c/a> and \u003ca href=\"https://www.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">UC San Francisco\u003c/a>, look for specific biomarkers in the mother's bloodstream.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Preterm delivery, which occurs when a baby is born before the 37th week of pregnancy, is the leading cause of death for children under 5 in the United States.\u003c/p>\n\u003cp>The \u003ca href=\"http://science.sciencemag.org/content/360/6393/1133\" target=\"_blank\" rel=\"noopener\">Stanford-led study\u003c/a>, predicts the risk of preterm birth using fetal RNA found in the mother's blood, while the \u003ca href=\"https://www.nature.com/articles/s41372-018-0112-0\" target=\"_blank\" rel=\"noopener\">UCSF study\u003c/a> focuses on inflammation markers.\u003c/p>\n\u003cp>There is currently one blood test on the market that screens for preterm risk, but it comes with serious limitations, according to \u003ca href=\"https://profiles.ucsf.edu/laura.jelliffe-pawlowski\" target=\"_blank\" rel=\"noopener\">Laura Jelliffe-Pawlowski\u003c/a>, co-author of the UCSF study and director of the \u003ca href=\"https://pretermbirth.ucsf.edu/\" target=\"_blank\" rel=\"noopener\">UCSF California Preterm Birth Initiative\u003c/a>. The costly test screens only for spontaneous preterm births. About three quarters of preterm births occur spontaneously while 25 percent are induced due to medical complications.\u003c/p>\n\u003caside class=\"pullquote alignright\">'We want to make sure that we're developing something that has the potential to help all women, including those most in need.’\u003ccite>Laura Jelliffe-Pawlowski, UCSF \u003c/cite>\u003c/aside>\n\u003cp>But for practitioners like \u003ca href=\"https://www.ucsfhealth.org/juan.gonzalez-velez\" target=\"_blank\" rel=\"noopener\">Dr. Juan Gonzalez\u003c/a>, a perinatologist at UCSF Medical Center, knowing whether a pregnancy is high-risk is not all that helpful without being able to adequately treat the problem.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"A patient can have a positive result but we need to know which intervention is the right intervention. This is a great finding but now we need those next steps, which are studies that focus on interventions. That's the part we don’t really know.\"\u003c/p>\n\u003cp>\u003ca href=\"https://www.mayoclinic.org/biographies/butler-tobah-yvonne-s-m-d/bio-20113896\" target=\"_blank\" rel=\"noopener\">Dr. Yvonne Butler Tobah\u003c/a>, a Mayo obstetrician, called the developments \"groundbreaking\" but warned that further research is required before it can be instituted clinically.\u003c/p>\n\u003cp>\u003cstrong>Causes of Preterm Birth\u003c/strong>\u003c/p>\n\u003cp>The causes of pre-term birth are not well understood, but doctors look for certain traits associated with the risk, according to\u003c/p>\n\u003cp>\"So we know things like hypertension and diabetes are associated with preterm birth,\" says Jelliffe-Pawlowski. \"And also the kinds of things that the test picks up, like inflammation, is associated with preterm birth.\"\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The UCSF study also looked at income and age of the pregnant women, two factors that exert an independent influence on bodily inflammation and placenta function, according to Jelliffe-Pawlowski. Mothers over the age of 34 are found to be at higher risk of inflammation levels.\u003c/p>\n\u003cp>An underlying infection, exposure to environmental toxins, stress, or chronic ailments like diabetes, can all trigger an inflammatory response in pregnant women, a condition that has potential to induce an early pregnancy.\u003c/p>\n\u003cp>A subset of women who test positive for preterm risk have a severe pregnancy complication called preeclampsia. The potentially fatal condition is characterized by high blood pressure and organ failure in the mother.\u003c/p>\n\u003cp>\u003cb>Treatments are Limited\u003c/b>\u003c/p>\n\u003cp>Current medical treatments are typically limited to cases of preeclampsia, and involve taking aspirin, which Jelliffe-Pawlowski says reduces the occurrence of preeclampsia by up to 30 percent.\u003c/p>\n\u003cp>For women with a prior history of preterm delivery, there is a progesterone supplement that is currently offered to decrease the risk, according to Tobah.\u003c/p>\n\u003cp>\"Prior preterm birth confers about a two fold increased risk,\" she said.\u003c/p>\n\u003cp>But outside of this limited category of high-risk pregnancies, there isn't much doctors can recommend in the way of decreasing preterm risk -- outside of bed rest, according to Gonzalez.\u003c/p>\n\u003cp>And preeclampsia comprises just 15 percent of all preterm births, making preventative care for the great majority of preterm cases all the more urgent, says Gonzalez.\u003c/p>\n\u003cp>\"Before doctors start running these tests, we really need to know what are we going to tell these women besides, 'You’re at risk,'\" he says.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But for the researchers involved in both studies, affordability and accessibility played an important role in the tests' development.\u003c/p>\n\u003cp>\"While the current available treatments are not great, I do think they have some effect,\" says co-author \u003ca href=\"https://profiles.stanford.edu/mads-melbye\" target=\"_blank\" rel=\"noopener\">Mads Melbye\u003c/a>, a professor in medical epidemiology at the University of Copenhagen, Denmark. \"For instance, if you know a woman is likely to deliver a preterm baby, you would likely refer her to a specialized hospital. And certainly the knowledge alone is important.\"\u003c/p>\n\u003cp>For Jelliffe-Pawlowski, helping pregnant women in disadvantaged communities was a huge motivator for developing the test.\u003c/p>\n\u003cp>\"What we hear from women in the community, particularly black and Latina women, is what's really important to them, is knowing their risk,\" says Jelliffe-Pawlowski. \"It's not necessary that we fix it, but there's an opportunity to communicate risk with women so they can be taken care of appropriately.\"\u003c/p>\n\u003cp>And Melbye says accurate tests are important, since inaccurate estimates can lead to unnecessary treatments such as the induction of labor or Cesarean sections.\u003c/p>\n\u003cp>\u003cstrong>Measuring Risk Through RNA\u003c/strong>\u003c/p>\n\u003cp>The Stanford-led study, published last week in the journal Science, measured cell-free fetal RNA in the mothers' bloodstream to determine the due date and preterm risk.\u003c/p>\n\u003cp>The researchers compared the blood results of women who had healthy pregnancies with those found to be at high risk for preterm delivery. They accurately predicted six of eight preterm cases and wrongly classified only one of 26 full-term cases.\u003c/p>\n\u003cp>But the Stanford test is a pilot study based on a limited number of women.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"The next step will be to apply the findings to large clinical trials,\" says Melbye. \"The study is just the first in a series of studies that allows us to look at the different outcomes of pregnancy. The hope is that it will lead to healthier and safer pregnancies.\"\u003c/p>\n\u003cp>\u003cstrong>Measuring Risk Through Inflammation\u003c/strong>\u003c/p>\n\u003cp>The UCSF test focused on 63 biomarkers in the mother's bloodstream related to inflammation and placenta function. From there, researchers narrowed the test down to 25 biomarkers that together help to predict the chances of an early pregnancy.\u003c/p>\n\u003cp>The study, published in the May issue of \u003ca href=\"https://www.nature.com/articles/s41372-018-0112-0\">\u003ci>Journal of Perinatology\u003c/i>\u003c/a>, is more than 80 percent accurate in predicting preterm births in women who are between 15 and 20 weeks pregnant.\u003c/p>\n\u003cp>In cases of high risk pregnancies, the test was nearly 90 percent accurate.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The UCSF test, which took five years to develop, is based on ten years of research by Jelliffe-Pawlowski's team. Researchers took blood samples from 400 women during their second trimester.\u003c/p>\n\u003cp>Researchers hope their blood tests will lead to better preventative treatments for women found to be at high risk of preterm birth.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We want to make sure that we're developing something that has the potential to help all women, including those most in need,\" says Jelliffe-Pawlowski.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/442039/new-blood-tests-promise-to-better-predict-early-labor","authors":["11428"],"categories":["futureofyou_1060","futureofyou_73"],"tags":["futureofyou_221","futureofyou_1283","futureofyou_164","futureofyou_520"],"featImg":"futureofyou_442044","label":"futureofyou"},"futureofyou_435960":{"type":"posts","id":"futureofyou_435960","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435960","score":null,"sort":[1509995619000]},"guestAuthors":[],"slug":"advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion","title":"Advanced Prenatal Testing Means More Gut-Wrenching Decisions Over Abortion","publishDate":1509995619,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>\u003cem>Excerpts from \"The Other Scarlet 'A': Abortion's Relationship to Genetic Testing\" from THE GENE MACHINE by Bonnie Rochman. Copyright © 2017 by Bonnie Rochman. Used by permission of \u003ca href=\"https://us.macmillan.com/fsg\" target=\"_blank\" rel=\"noopener\">Farrar, Straus and Giroux\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>When the second purple line appeared on the white plastic wand on a March morning in 2002, I knew next to nothing about pregnancy and even less about raising a child. It was years before I’d go on to cover parenting and pediatrics, and write about sequencing children’s genomes. Yet from the first days of that pregnancy, I was already enmeshed in the most cutting-edge technologies of the time, thanks to my friend Tali, whose son was due a week after mine.\u003c/p>\n\u003caside class=\"pullquote alignright\">How people feel about disability and how that impacts their decisions around abortion are the real topics in any discussion about advanced prenatal testing.\u003c/aside>\n\u003cp>Tali had recently moved to my home state of North Carolina from Israel, where nuchal translucency testing was standard. I had no idea what it was, but I figured it was important, judging by her level of outrage that this test to gauge Down syndrome risk — combination of an ultrasound to measure the collection of fluid under the skin on the back of a fetus’s neck, and a blood draw — wasn’t commonly available in the United States. Within days, she told me that she’d found a doctor who was getting certified to perform the testing. He needed subjects. Tali and I volunteered.\u003c/p>\n\u003cp>I had signed up blithely, without seriously considering what I’d do if the test result came back positive. I expected good news — and, fortunately, I got it. Now, more than a decade later, nuchal translucency is old hat. Other, more sophisticated tests have begun to usurp what was lauded as the latest in prenatal technology in the early aughts.\u003c/p>\n\u003cp>Nuchal translucency offered both Tali and me reassurance. But the various permutations of prenatal screening and testing do not always provide comfort. I am witness to that in the heart of midtown Manhattan, not far from Radio City Music Hall, in a clinic where a woman and her husband have just made a life-altering decision. The woman is 40 years old, with high cheekbones and skin the color of toasted almonds. She is 12-and-a-half weeks pregnant with one baby, but minutes earlier, before she sat down with me in an empty exam room, she was pregnant with two.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"i4qdnvXQQLlENO4hP9XlMVjlFUStRjgc\"]Her journey to motherhood had not been easy. The twins had been conceived via in vitro fertilization after the woman and her partner had spent more than a year trying to get pregnant the old-fashioned way. A week before, she had had a microarray analysis that peered deeply into the genetic makeup of her twins.\u003c/p>\n\u003cp>Microarray analyzes fetal cells for countless less apparent disorders that occur when a tiny snippet of DNA has been added somewhere it’s not supposed to be or deleted entirely, revealing genetic hiccups that previously could not be detected prenatally. Some of these changes are meaningless; others may be associated with autism or rare disorders such as DiGeorge syndrome, which is characterized by heart problems and a roughly 25 percent risk of developing schizophrenia.\u003c/p>\n\u003cp>As the woman explained, “We made use of technology throughout this process, so it would be a shame not to take advantage of this [test]. I wanted to make sure that, given my age, there was nothing wrong.”\u003c/p>\n\u003cp>She knew that the microarray would reveal all sorts of genetic blips, DNA duplications and deletions too tiny to be seen under a microscope, some of which are associated with worrisome conditions and others of which aren’t understood. The test would also detect major chromosomal problems, of which Down syndrome is the most common.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Just because a patient can know something, must she? What is one of the most joyous times of life has turned into something ominous and fraught, loaded with the potential to go wrong.'\u003c/aside>\n\u003cp>Even at age 40, just 1 of 100 pregnancies results in Down syndrome. And yet the couple beat those odds: one of the twins was confirmed to have the extra 21st chromosome that causes the condition.\u003c/p>\n\u003cp>“You don’t think it’s going to happen to you and then here it is. I still can’t get over the fact. Today we reduced the baby with Down syndrome,” the woman tells me, using a common euphemism for terminating one or more fetuses in cases where a woman is carrying more than she intends to deliver. Many doctors call this “fetal reduction.” She reflects on her decision, made possible by these new tests, as she lowers herself onto an exam table to rest. “I look at this as a sign from God. My mother believes in karma. I think this baby was only meant to be for twelve weeks and his suffering was shortened,” she says. She raises herself up on her elbows and looks at her husband. “Then I feel like, ‘Oh my god, I just killed a baby.’ ”\u003c/p>\n\u003cp>Considering that women have been getting pregnant for a very long time, prenatal diagnosis — the ability to peer inside the womb and emerge with a snapshot of fetal health — is a fairly recent development, a convergence of medical technologies such as amniocentesis and ultrasound with emerging insights about genes and chromosomes. But it’s the legalization of abortion in 1973 that really served as a catalyst for change. After all, without the ability to choose whether or not to continue a pregnancy, knowledge gleaned from prenatal diagnosis would have remained largely theoretical. With the decriminalization of abortion, what to do became a choice.\u003c/p>\n\u003cp>While there are women who’d never opt for an abortion, it’s disingenuous to ignore the fact that terminating a pregnancy is one possible outcome of earlier, more sophisticated genetic tests. The issue of how people feel about disability and, in turn, how that impacts their decisions regarding abortion is an essential aspect of any discussion about advances in prenatal testing.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I don't understand why even women in their twenties aren't undergoing this testing. Knowledge is power.'\u003c/aside>\n\u003cp>Yet abortion remains the elephant in the room when it comes to prenatal testing. When I discuss my work with colleagues and friends interested in the subject, some say, “ You’re not going to mention abortion, are you? My gut tells me that I think you’re walking into a minefield if that becomes a major part of the book.” Others say, “Abortion should definitely be a chapter. How could it not be?”\u003c/p>\n\u003cp>Much of the prenatal testing conversation centers on Down syndrome because the condition is so well- known, unlike others that affect far fewer people. One of every 792 babies born in the United States has Down syndrome. Compared to many other chromosomal conditions, however, Down syndrome is considered a relatively mild genetic complex. Chromosome 21 is the smallest chromosome, so the extra genetic material that accompanies a third copy is not as massive or overwhelming as it would be had it occurred on another, larger chromosome. The genetic disorder that results from a triplication of any chromosome is called a trisomy. A trisomy 22 baby, for example, probably would not make it to birth.\u003c/p>\n\u003cp>Starting in the 1970s, various epidemiologists began making the case that standardizing testing for Down syndrome was a public health priority. Since then, screening for Down syndrome has become broadly accepted by the medical community and, in turn, by many pregnant women and their partners. In 2007, the American College of Obstetrics and Gynecology expanded its prenatal screening recommendations to offer all women, regardless of age, the option of screening and diagnosis for genetic conditions, including Down syndrome.\u003c/p>\n\u003cp>One of the consequences is clear. In 2015, Brian Skotko, who co-directs the Down Syndrome Program at Massachusetts General Hospital, published a comprehensive look at Down syndrome live-birth rates in the United States. Between 2006 and 2010, he and his colleagues calculated that 30 percent fewer babies with Down syndrome were born than were expected, due to elective terminations.\u003c/p>\n\u003cp>Decisions about whether to have a baby with Down syndrome tend to vary geographically and by level of education. In the 2015 study, abortions for reasons of Down syndrome were highest in the Northeast and Hawaii and lowest in the South. Asians were the most likely to terminate due to Down syndrome, while Hispanics and American Indians were the least likely.\u003c/p>\n\u003cfigure id=\"attachment_370960\" class=\"wp-caption aligncenter\" style=\"max-width: 507px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/04/Down-syndrome.jpg\">\u003cimg class=\"size-full wp-image-370960\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/04/Down-syndrome.jpg\" alt=\"\" width=\"507\" height=\"337\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/04/Down-syndrome.jpg 507w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Down-syndrome-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Down-syndrome-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Down-syndrome-375x249.jpg 375w\" sizes=\"(max-width: 507px) 100vw, 507px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A baby girl with Down Syndrome and her mother. \u003ccite>( JGI/Tom Grill/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>The Rise of Noninvasive Prenatal Screening \u003c/strong>\u003c/p>\n\u003cp>Various forms of prenatal testing have been around for decades, but when noninvasive prenatal screening (NIPS) debuted in 2011, its greater accuracy combined with its ease of use contributed to its rapid uptake. In a few short years, NIPS, also called cell-free DNA screening, has become pervasive in the prenatal-testing market. Rather than face off with a long needle or catheter guided through the cervix or abdomen late in the first trimester, or a long needle in the abdomen in the second trimester, a quick venipuncture can collect enough blood midway through the first trimester to gauge whether the fetus’s chromosomes are intact, with high accuracy and no in utero assault. Within a few weeks of a woman learning she’s pregnant, her blood contains fragments of fetal DNA (NIPS actually detects DNA from the placenta, considered a proxy for fetal DNA, that is free-floating in the mom’s bloodstream). The amount of cell- free DNA from the fetus and mother can then be analyzed to predict Down syndrome (and an increasing number of other chromosomal conditions) with up to 99 percent accuracy — though the concept of accuracy itself is nuanced and complex and fluctuates depending on the age of the mother. NIPS, being a blood test, also sidesteps the very small but still scary risk of miscarriage that accompanies CVS (short for \u003ca href=\"https://www.mayoclinic.org/tests-procedures/chorionic-villus-sampling/basics/definition/prc-20013566\" target=\"_blank\" rel=\"noopener\">chorionic villus sampling\u003c/a>) or amnio.\u003c/p>\n\u003caside class=\"pullquote alignright\">The doctor said: 'I get people coming in here who ... want to know this is 100 percent fine. I can't give you 100 percent. I can give you 80 percent. And I said, \"I'm going to take those odds.\"\u003c/aside>\n\u003cp>Initially reserved for women over 35, NIPS has now spread to younger women as well, and has spawned a $500 million industry expected to balloon to $2 billion by 2020. But who gets the testing ranges widely, depending upon who goes to the doctor in the first place. Lower-income women, due to lack of access, don’t seek out prenatal care nearly as regularly as more well-to-do mothers. If they do, they’re often too far along in their pregnancies to get screened. Due to geographic discrepancies in Medicaid coverage, NIPS or other tests may not be covered. ...\u003c/p>\n\u003cp>Despite its high degree of accuracy, NIPS is not perfect. Nor does it equate with a diagnosis. NIPS is a screening test; it can be complicated by a lower-than-expected fraction of fetal DNA and even by an underlying maternal cancer diagnosis. Only CVS or amnio can offer confirmation. But the message is not always getting across to women — or their doctors. Cases have been reported of women coming close to terminating pregnancies they believed were affected based on NIPS results — only to learn that they were not. Experts blame the companies that market the tests for robust advertising that they say misleads patients — and some physicians — into believing that the results are equivalent to a diagnosis. To address misunderstanding, the American Congress of Obstetricians and Gynecologists issued a statement in 2015 stressing that any positive results need to be confirmed via other tests such as amniocentesis. In other words, ACOG emphasizes, a decision to have an abortion should not be based solely on the results of NIPS.\u003c/p>\n\u003cp>Yet there has been little public conversation about widespread prenatal screening and the “consequences of the transformation of every fetus — and not only the precious fetus produced thanks to complex technological interventions — into an ‘at risk’ entity, extensively tested, measured and evaluated by health professionals,” wrote the science historian Ilana Löwy in a paper about prenatal diagnosis.\u003c/p>\n\u003cp>In an op-ed in The New York Times, “\u003ca href=\"https://opinionator.blogs.nytimes.com/2014/06/04/the-t-m-i-pregnancy/?_r=0\" target=\"_blank\" rel=\"noopener\">The T.M.I. Pregnancy,\u003c/a>” Patricia Volk lamented that all the testing surrounding her daughter-in-law’s supposedly “normal” pregnancy had left them both feeling “guardedly happy.” She recounted a series of scary ultrasound findings that turned out to be nothing, and mused: “Prenatal science has helped a lot [of] people and people-to-be. But just because a patient can know something, must she? Odds are in this baby’s favor, yet every sonogram adds something scary to the pot. What is one of the most joyous times of life has turned into something ominous and fraught, loaded with the potential to go wrong.”\u003c/p>\n\u003cp>Yet one person’s anxiety is another’s sigh of relief. The debate over what testing and how much hinges on so many factors. In fact, two letters to the editor in response to “The T.M.I. Pregnancy” highlight why this push-and-pull is one of the great medical and social conundrums of our time. In one, Alastair Pullen describes his experience declining all testing during his wife’s first pregnancy “for all of the reasons this article mentions.” Halfway through the pregnancy, he and his wife agreed to an ultrasound and discovered their daughter had a fatal condition and would not survive long after birth. “Faced with a horrible decision,” Pullen writes, “we decided to induce preterm labor. Becket was stillborn. The only thing worse would have been if we had had no knowledge of her condition.” Pullen had first decided not to test but ended up grateful he changed his mind. He and his wife welcomed testing in later pregnancies; they now have three healthy children, and, he says, “the barrage of testing affirmed our excitement.”\u003c/p>\n\u003cp>Ingrid Chafee, on the other hand, gave birth when no tests were available. She was shocked when she delivered her firstborn in 1965, only to learn he had hydrocephalus and spina bifida. Surgery repaired much of the damage, but her son — who now holds a doctorate from Oxford — still has physical problems. She concludes: “He has said many times that he is glad that there were no ultrasound tests available at the time of his birth. If there had been, he wouldn’t be here. To know or not to know? It’s up to each to decide.”\u003c/p>\n\u003cp>\u003cstrong>Who Is a Gift and Who a Burden?\u003c/strong>\u003c/p>\n\u003cp>The ethics of abortion are set to become much more complicated as more women have access to powerful genetic tests such as microarray, for these tests can identify genetic flaws that are not readily understood.\u003c/p>\n\u003cp>Microarray had confirmed that the almond skinned woman who had the fetal reduction was carrying one twin with Down syndrome. But in the case of more ambiguous genetic errors in a boy named Ryan Docherty, confirmation was the easy part. It was the interpretation — figuring out the significance of the problems that microarray had detected in utero — that proved difficult.\u003c/p>\n\u003cp>When she was pregnant, Ryan’s mom, Jen Sipress, had a microarray test. You’ll recall that chromosomal microarray analysis can detect deletions and duplications of genetic material — errors that are far smaller than an entire extra chromosome. But just because they’re smaller doesn’t mean they can’t wreak havoc. Some are associated with genetic disorders; many more aren’t associated with anything because they’re so newly discovered or because they don’t appear to be detrimental according to the limited amount of research that exists. Sipress, 42, is a New York City narcotics prosecutor; she thrives on evidence. When her test results came back, the evidence was disconcerting: Ryan, still in utero, had not one but two findings — “variants of uncertain significance” — inherited from his mother and his father. Docherty had passed down a duplication involving six genes, while Sipress had contributed a deletion on chromosome 15 involving four genes. In general, deletions are considered more worrisome than duplications; our bodies can often deal with some extra genetic material, but it’s not as easy to compensate for DNA gone AWOL. To make matters worse, one of the four missing genes had been associated in the medical literature with intellectual and developmental delay. Here’s where things got really confusing: Sipress was missing that same gene and she didn’t appear to be affected at all. She worked hard as the family’s primary income earner, putting drug dealers behind bars. She hadn’t even known she was missing any genes until the microarray results came back. But genes—or their absence — can affect people differently; it’s a phenomenon called “variable expressivity.”\u003c/p>\n\u003cp>Before the amniocentesis to collect fetal cells for the microarray analysis, Sipress and Docherty had decided that were they to learn that their unborn child wouldn’t be able to live independently as an adult, they would end the pregnancy. When they got the results, they leaned toward abortion. After talking to their doctor, Ron Wapner, author of a \u003cem>New England Journal of Medicine\u003c/em> study about microarray’s effectiveness, they changed their minds. As Sipress recalls, Wapner said, “‘I get people coming in here who . . . want to know this is 100 percent fine.’ And he said, ‘I can’t give you 100 percent. I can give you 80 percent.’ And I said, ‘I’m going to take those odds.’ ”\u003c/p>\n\u003cp>Emotionally, it was a terrible time for Sipress and Docherty. Ryan was their first child, and he had been conceived after two rounds of IVF. But Sipress doesn’t regret finding out. “I don’t understand why even women in their 20s aren’t undergoing this testing,” she says. “Knowledge is power. Doesn’t everyone realize that?”\u003c/p>\n\u003cp>It’s certainly made for some awkward conversations with her husband’s family in Scotland, who know about the missing genes. “They ask if there is something wrong with the kid, and I say, ‘Technically, yes, but he’s not exhibiting any symptoms,’ ” says Sipress. To that end, Docherty, who stays home with Ryan, is a vigilant observer. “Are we still worried?” says Docherty. “Absolutely.” It’s easy to attribute every behavioral challenge — Ryan’s not a good sleeper, but neither are lots of babies — to the missing genes. Anticipating this, Wapner has cautioned them against engaging in this sort of genetic determinism. “He said, ‘Go about your business. If you feel something is really wrong, then you act.’ To be honest,” says Docherty, “Ryan doesn’t have a problem, as far as I can see.”\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>To what end are we willing to go to detect disability? Once we find it, is there a dividing line between “good,” or tolerable, disabilities and “bad,” or intolerable, limitations? How do we decide which ones may warrant abortion and which are acceptable? What feels overwhelming to one person— the birth of a child with a genetic disorder— may feel like God’s gift to another. Who are we to judge what — who, more accurately—is a gift and who is a burden?\u003c/p>\n\n","blocks":[],"excerpt":"Advanced prenatal genetic testing transforms every fetus into an 'at risk' entity. And we should be talking about that, says author Bonnie Rochman in 'The Gene Machine.'","status":"publish","parent":0,"modified":1514584359,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":36,"wordCount":3388},"headData":{"title":"Advanced Prenatal Testing Means More Gut-Wrenching Decisions Over Abortion | KQED","description":"Advanced prenatal genetic testing transforms every fetus into an 'at risk' entity. And we should be talking about that, says author Bonnie Rochman in 'The Gene Machine.'","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Advanced Prenatal Testing Means More Gut-Wrenching Decisions Over Abortion","datePublished":"2017-11-06T19:13:39.000Z","dateModified":"2017-12-29T21:52:39.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"435960 https://ww2.kqed.org/futureofyou/?p=435960","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/11/06/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion/","disqusTitle":"Advanced Prenatal Testing Means More Gut-Wrenching Decisions Over Abortion","nprByline":"Bonnie Rochman","path":"/futureofyou/435960/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Excerpts from \"The Other Scarlet 'A': Abortion's Relationship to Genetic Testing\" from THE GENE MACHINE by Bonnie Rochman. Copyright © 2017 by Bonnie Rochman. Used by permission of \u003ca href=\"https://us.macmillan.com/fsg\" target=\"_blank\" rel=\"noopener\">Farrar, Straus and Giroux\u003c/a>.\u003c/em>\u003c/p>\n\u003cp>When the second purple line appeared on the white plastic wand on a March morning in 2002, I knew next to nothing about pregnancy and even less about raising a child. It was years before I’d go on to cover parenting and pediatrics, and write about sequencing children’s genomes. Yet from the first days of that pregnancy, I was already enmeshed in the most cutting-edge technologies of the time, thanks to my friend Tali, whose son was due a week after mine.\u003c/p>\n\u003caside class=\"pullquote alignright\">How people feel about disability and how that impacts their decisions around abortion are the real topics in any discussion about advanced prenatal testing.\u003c/aside>\n\u003cp>Tali had recently moved to my home state of North Carolina from Israel, where nuchal translucency testing was standard. I had no idea what it was, but I figured it was important, judging by her level of outrage that this test to gauge Down syndrome risk — combination of an ultrasound to measure the collection of fluid under the skin on the back of a fetus’s neck, and a blood draw — wasn’t commonly available in the United States. Within days, she told me that she’d found a doctor who was getting certified to perform the testing. He needed subjects. Tali and I volunteered.\u003c/p>\n\u003cp>I had signed up blithely, without seriously considering what I’d do if the test result came back positive. I expected good news — and, fortunately, I got it. Now, more than a decade later, nuchal translucency is old hat. Other, more sophisticated tests have begun to usurp what was lauded as the latest in prenatal technology in the early aughts.\u003c/p>\n\u003cp>Nuchal translucency offered both Tali and me reassurance. But the various permutations of prenatal screening and testing do not always provide comfort. I am witness to that in the heart of midtown Manhattan, not far from Radio City Music Hall, in a clinic where a woman and her husband have just made a life-altering decision. The woman is 40 years old, with high cheekbones and skin the color of toasted almonds. She is 12-and-a-half weeks pregnant with one baby, but minutes earlier, before she sat down with me in an empty exam room, she was pregnant with two.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>Her journey to motherhood had not been easy. The twins had been conceived via in vitro fertilization after the woman and her partner had spent more than a year trying to get pregnant the old-fashioned way. A week before, she had had a microarray analysis that peered deeply into the genetic makeup of her twins.\u003c/p>\n\u003cp>Microarray analyzes fetal cells for countless less apparent disorders that occur when a tiny snippet of DNA has been added somewhere it’s not supposed to be or deleted entirely, revealing genetic hiccups that previously could not be detected prenatally. Some of these changes are meaningless; others may be associated with autism or rare disorders such as DiGeorge syndrome, which is characterized by heart problems and a roughly 25 percent risk of developing schizophrenia.\u003c/p>\n\u003cp>As the woman explained, “We made use of technology throughout this process, so it would be a shame not to take advantage of this [test]. I wanted to make sure that, given my age, there was nothing wrong.”\u003c/p>\n\u003cp>She knew that the microarray would reveal all sorts of genetic blips, DNA duplications and deletions too tiny to be seen under a microscope, some of which are associated with worrisome conditions and others of which aren’t understood. The test would also detect major chromosomal problems, of which Down syndrome is the most common.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Just because a patient can know something, must she? What is one of the most joyous times of life has turned into something ominous and fraught, loaded with the potential to go wrong.'\u003c/aside>\n\u003cp>Even at age 40, just 1 of 100 pregnancies results in Down syndrome. And yet the couple beat those odds: one of the twins was confirmed to have the extra 21st chromosome that causes the condition.\u003c/p>\n\u003cp>“You don’t think it’s going to happen to you and then here it is. I still can’t get over the fact. Today we reduced the baby with Down syndrome,” the woman tells me, using a common euphemism for terminating one or more fetuses in cases where a woman is carrying more than she intends to deliver. Many doctors call this “fetal reduction.” She reflects on her decision, made possible by these new tests, as she lowers herself onto an exam table to rest. “I look at this as a sign from God. My mother believes in karma. I think this baby was only meant to be for twelve weeks and his suffering was shortened,” she says. She raises herself up on her elbows and looks at her husband. “Then I feel like, ‘Oh my god, I just killed a baby.’ ”\u003c/p>\n\u003cp>Considering that women have been getting pregnant for a very long time, prenatal diagnosis — the ability to peer inside the womb and emerge with a snapshot of fetal health — is a fairly recent development, a convergence of medical technologies such as amniocentesis and ultrasound with emerging insights about genes and chromosomes. But it’s the legalization of abortion in 1973 that really served as a catalyst for change. After all, without the ability to choose whether or not to continue a pregnancy, knowledge gleaned from prenatal diagnosis would have remained largely theoretical. With the decriminalization of abortion, what to do became a choice.\u003c/p>\n\u003cp>While there are women who’d never opt for an abortion, it’s disingenuous to ignore the fact that terminating a pregnancy is one possible outcome of earlier, more sophisticated genetic tests. The issue of how people feel about disability and, in turn, how that impacts their decisions regarding abortion is an essential aspect of any discussion about advances in prenatal testing.\u003c/p>\n\u003caside class=\"pullquote alignright\">'I don't understand why even women in their twenties aren't undergoing this testing. Knowledge is power.'\u003c/aside>\n\u003cp>Yet abortion remains the elephant in the room when it comes to prenatal testing. When I discuss my work with colleagues and friends interested in the subject, some say, “ You’re not going to mention abortion, are you? My gut tells me that I think you’re walking into a minefield if that becomes a major part of the book.” Others say, “Abortion should definitely be a chapter. How could it not be?”\u003c/p>\n\u003cp>Much of the prenatal testing conversation centers on Down syndrome because the condition is so well- known, unlike others that affect far fewer people. One of every 792 babies born in the United States has Down syndrome. Compared to many other chromosomal conditions, however, Down syndrome is considered a relatively mild genetic complex. Chromosome 21 is the smallest chromosome, so the extra genetic material that accompanies a third copy is not as massive or overwhelming as it would be had it occurred on another, larger chromosome. The genetic disorder that results from a triplication of any chromosome is called a trisomy. A trisomy 22 baby, for example, probably would not make it to birth.\u003c/p>\n\u003cp>Starting in the 1970s, various epidemiologists began making the case that standardizing testing for Down syndrome was a public health priority. Since then, screening for Down syndrome has become broadly accepted by the medical community and, in turn, by many pregnant women and their partners. In 2007, the American College of Obstetrics and Gynecology expanded its prenatal screening recommendations to offer all women, regardless of age, the option of screening and diagnosis for genetic conditions, including Down syndrome.\u003c/p>\n\u003cp>One of the consequences is clear. In 2015, Brian Skotko, who co-directs the Down Syndrome Program at Massachusetts General Hospital, published a comprehensive look at Down syndrome live-birth rates in the United States. Between 2006 and 2010, he and his colleagues calculated that 30 percent fewer babies with Down syndrome were born than were expected, due to elective terminations.\u003c/p>\n\u003cp>Decisions about whether to have a baby with Down syndrome tend to vary geographically and by level of education. In the 2015 study, abortions for reasons of Down syndrome were highest in the Northeast and Hawaii and lowest in the South. Asians were the most likely to terminate due to Down syndrome, while Hispanics and American Indians were the least likely.\u003c/p>\n\u003cfigure id=\"attachment_370960\" class=\"wp-caption aligncenter\" style=\"max-width: 507px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/04/Down-syndrome.jpg\">\u003cimg class=\"size-full wp-image-370960\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2017/04/Down-syndrome.jpg\" alt=\"\" width=\"507\" height=\"337\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2017/04/Down-syndrome.jpg 507w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Down-syndrome-160x106.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Down-syndrome-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2017/04/Down-syndrome-375x249.jpg 375w\" sizes=\"(max-width: 507px) 100vw, 507px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">A baby girl with Down Syndrome and her mother. \u003ccite>( JGI/Tom Grill/Getty Images)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>The Rise of Noninvasive Prenatal Screening \u003c/strong>\u003c/p>\n\u003cp>Various forms of prenatal testing have been around for decades, but when noninvasive prenatal screening (NIPS) debuted in 2011, its greater accuracy combined with its ease of use contributed to its rapid uptake. In a few short years, NIPS, also called cell-free DNA screening, has become pervasive in the prenatal-testing market. Rather than face off with a long needle or catheter guided through the cervix or abdomen late in the first trimester, or a long needle in the abdomen in the second trimester, a quick venipuncture can collect enough blood midway through the first trimester to gauge whether the fetus’s chromosomes are intact, with high accuracy and no in utero assault. Within a few weeks of a woman learning she’s pregnant, her blood contains fragments of fetal DNA (NIPS actually detects DNA from the placenta, considered a proxy for fetal DNA, that is free-floating in the mom’s bloodstream). The amount of cell- free DNA from the fetus and mother can then be analyzed to predict Down syndrome (and an increasing number of other chromosomal conditions) with up to 99 percent accuracy — though the concept of accuracy itself is nuanced and complex and fluctuates depending on the age of the mother. NIPS, being a blood test, also sidesteps the very small but still scary risk of miscarriage that accompanies CVS (short for \u003ca href=\"https://www.mayoclinic.org/tests-procedures/chorionic-villus-sampling/basics/definition/prc-20013566\" target=\"_blank\" rel=\"noopener\">chorionic villus sampling\u003c/a>) or amnio.\u003c/p>\n\u003caside class=\"pullquote alignright\">The doctor said: 'I get people coming in here who ... want to know this is 100 percent fine. I can't give you 100 percent. I can give you 80 percent. And I said, \"I'm going to take those odds.\"\u003c/aside>\n\u003cp>Initially reserved for women over 35, NIPS has now spread to younger women as well, and has spawned a $500 million industry expected to balloon to $2 billion by 2020. But who gets the testing ranges widely, depending upon who goes to the doctor in the first place. Lower-income women, due to lack of access, don’t seek out prenatal care nearly as regularly as more well-to-do mothers. If they do, they’re often too far along in their pregnancies to get screened. Due to geographic discrepancies in Medicaid coverage, NIPS or other tests may not be covered. ...\u003c/p>\n\u003cp>Despite its high degree of accuracy, NIPS is not perfect. Nor does it equate with a diagnosis. NIPS is a screening test; it can be complicated by a lower-than-expected fraction of fetal DNA and even by an underlying maternal cancer diagnosis. Only CVS or amnio can offer confirmation. But the message is not always getting across to women — or their doctors. Cases have been reported of women coming close to terminating pregnancies they believed were affected based on NIPS results — only to learn that they were not. Experts blame the companies that market the tests for robust advertising that they say misleads patients — and some physicians — into believing that the results are equivalent to a diagnosis. To address misunderstanding, the American Congress of Obstetricians and Gynecologists issued a statement in 2015 stressing that any positive results need to be confirmed via other tests such as amniocentesis. In other words, ACOG emphasizes, a decision to have an abortion should not be based solely on the results of NIPS.\u003c/p>\n\u003cp>Yet there has been little public conversation about widespread prenatal screening and the “consequences of the transformation of every fetus — and not only the precious fetus produced thanks to complex technological interventions — into an ‘at risk’ entity, extensively tested, measured and evaluated by health professionals,” wrote the science historian Ilana Löwy in a paper about prenatal diagnosis.\u003c/p>\n\u003cp>In an op-ed in The New York Times, “\u003ca href=\"https://opinionator.blogs.nytimes.com/2014/06/04/the-t-m-i-pregnancy/?_r=0\" target=\"_blank\" rel=\"noopener\">The T.M.I. Pregnancy,\u003c/a>” Patricia Volk lamented that all the testing surrounding her daughter-in-law’s supposedly “normal” pregnancy had left them both feeling “guardedly happy.” She recounted a series of scary ultrasound findings that turned out to be nothing, and mused: “Prenatal science has helped a lot [of] people and people-to-be. But just because a patient can know something, must she? Odds are in this baby’s favor, yet every sonogram adds something scary to the pot. What is one of the most joyous times of life has turned into something ominous and fraught, loaded with the potential to go wrong.”\u003c/p>\n\u003cp>Yet one person’s anxiety is another’s sigh of relief. The debate over what testing and how much hinges on so many factors. In fact, two letters to the editor in response to “The T.M.I. Pregnancy” highlight why this push-and-pull is one of the great medical and social conundrums of our time. In one, Alastair Pullen describes his experience declining all testing during his wife’s first pregnancy “for all of the reasons this article mentions.” Halfway through the pregnancy, he and his wife agreed to an ultrasound and discovered their daughter had a fatal condition and would not survive long after birth. “Faced with a horrible decision,” Pullen writes, “we decided to induce preterm labor. Becket was stillborn. The only thing worse would have been if we had had no knowledge of her condition.” Pullen had first decided not to test but ended up grateful he changed his mind. He and his wife welcomed testing in later pregnancies; they now have three healthy children, and, he says, “the barrage of testing affirmed our excitement.”\u003c/p>\n\u003cp>Ingrid Chafee, on the other hand, gave birth when no tests were available. She was shocked when she delivered her firstborn in 1965, only to learn he had hydrocephalus and spina bifida. Surgery repaired much of the damage, but her son — who now holds a doctorate from Oxford — still has physical problems. She concludes: “He has said many times that he is glad that there were no ultrasound tests available at the time of his birth. If there had been, he wouldn’t be here. To know or not to know? It’s up to each to decide.”\u003c/p>\n\u003cp>\u003cstrong>Who Is a Gift and Who a Burden?\u003c/strong>\u003c/p>\n\u003cp>The ethics of abortion are set to become much more complicated as more women have access to powerful genetic tests such as microarray, for these tests can identify genetic flaws that are not readily understood.\u003c/p>\n\u003cp>Microarray had confirmed that the almond skinned woman who had the fetal reduction was carrying one twin with Down syndrome. But in the case of more ambiguous genetic errors in a boy named Ryan Docherty, confirmation was the easy part. It was the interpretation — figuring out the significance of the problems that microarray had detected in utero — that proved difficult.\u003c/p>\n\u003cp>When she was pregnant, Ryan’s mom, Jen Sipress, had a microarray test. You’ll recall that chromosomal microarray analysis can detect deletions and duplications of genetic material — errors that are far smaller than an entire extra chromosome. But just because they’re smaller doesn’t mean they can’t wreak havoc. Some are associated with genetic disorders; many more aren’t associated with anything because they’re so newly discovered or because they don’t appear to be detrimental according to the limited amount of research that exists. Sipress, 42, is a New York City narcotics prosecutor; she thrives on evidence. When her test results came back, the evidence was disconcerting: Ryan, still in utero, had not one but two findings — “variants of uncertain significance” — inherited from his mother and his father. Docherty had passed down a duplication involving six genes, while Sipress had contributed a deletion on chromosome 15 involving four genes. In general, deletions are considered more worrisome than duplications; our bodies can often deal with some extra genetic material, but it’s not as easy to compensate for DNA gone AWOL. To make matters worse, one of the four missing genes had been associated in the medical literature with intellectual and developmental delay. Here’s where things got really confusing: Sipress was missing that same gene and she didn’t appear to be affected at all. She worked hard as the family’s primary income earner, putting drug dealers behind bars. She hadn’t even known she was missing any genes until the microarray results came back. But genes—or their absence — can affect people differently; it’s a phenomenon called “variable expressivity.”\u003c/p>\n\u003cp>Before the amniocentesis to collect fetal cells for the microarray analysis, Sipress and Docherty had decided that were they to learn that their unborn child wouldn’t be able to live independently as an adult, they would end the pregnancy. When they got the results, they leaned toward abortion. After talking to their doctor, Ron Wapner, author of a \u003cem>New England Journal of Medicine\u003c/em> study about microarray’s effectiveness, they changed their minds. As Sipress recalls, Wapner said, “‘I get people coming in here who . . . want to know this is 100 percent fine.’ And he said, ‘I can’t give you 100 percent. I can give you 80 percent.’ And I said, ‘I’m going to take those odds.’ ”\u003c/p>\n\u003cp>Emotionally, it was a terrible time for Sipress and Docherty. Ryan was their first child, and he had been conceived after two rounds of IVF. But Sipress doesn’t regret finding out. “I don’t understand why even women in their 20s aren’t undergoing this testing,” she says. “Knowledge is power. Doesn’t everyone realize that?”\u003c/p>\n\u003cp>It’s certainly made for some awkward conversations with her husband’s family in Scotland, who know about the missing genes. “They ask if there is something wrong with the kid, and I say, ‘Technically, yes, but he’s not exhibiting any symptoms,’ ” says Sipress. To that end, Docherty, who stays home with Ryan, is a vigilant observer. “Are we still worried?” says Docherty. “Absolutely.” It’s easy to attribute every behavioral challenge — Ryan’s not a good sleeper, but neither are lots of babies — to the missing genes. Anticipating this, Wapner has cautioned them against engaging in this sort of genetic determinism. “He said, ‘Go about your business. If you feel something is really wrong, then you act.’ To be honest,” says Docherty, “Ryan doesn’t have a problem, as far as I can see.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>To what end are we willing to go to detect disability? Once we find it, is there a dividing line between “good,” or tolerable, disabilities and “bad,” or intolerable, limitations? How do we decide which ones may warrant abortion and which are acceptable? What feels overwhelming to one person— the birth of a child with a genetic disorder— may feel like God’s gift to another. Who are we to judge what — who, more accurately—is a gift and who is a burden?\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435960/advanced-prenatal-testing-will-mean-more-gut-wrenching-decisions-about-abortion","authors":["byline_futureofyou_435960"],"categories":["futureofyou_452","futureofyou_1","futureofyou_1064"],"tags":["futureofyou_342","futureofyou_1439","futureofyou_587","futureofyou_1275","futureofyou_1015","futureofyou_120","futureofyou_80","futureofyou_1386","futureofyou_1388","futureofyou_520","futureofyou_1389"],"featImg":"futureofyou_436849","label":"futureofyou"},"futureofyou_435969":{"type":"posts","id":"futureofyou_435969","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435969","score":null,"sort":[1508276628000]},"guestAuthors":[],"slug":"ovarian-reserve-test-marketed-as-fertility-measure-doesnt-work-study","title":"Popular Fertility Test Doesn't Work, Study Says","publishDate":1508276628,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{"term":54,"site":"futureofyou"},"content":"\u003cp>Tests that measure a woman’s “ovarian reserve” to estimate how many more years of fertility she has have grown increasingly popular. But a new study finds that levels of the hormones commonly tested aren’t tied to lower chances of getting pregnant.\u003c/p>\n\u003cp class=\"danger-zone\">The new research, published in the \u003cem>Journal of the American Medical Association\u003c/em>, looked at three markers: anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Women with low values are going to have unnecessary anxiety, and women with high values may be incorrectly reassured.'\u003ccite>Dr. Anne Steiner, University of North Carolina\u003c/cite>\u003c/aside>\n\u003cp>That’s led to a boom in ovarian reserve testing, both in the clinic and with direct-to-consumer tests from companies. One startup, Modern Fertility, is pre-selling a new $149 fertility test that measures FSH, AMH, and other fertility hormones. The company says physicians will tally all those measures up and calculate a “fertility score.” Previous research has correlated levels of the three hormones with the number of eggs a woman has in her ovaries — a measure known as “ovarian reserve.” Studies have suggested that information could be used to predict how well a woman will respond to in vitro fertilization. But in recent years, as more women are delaying pregnancy until later ages, ovarian reserve tests have begun to be used as a way to test for future fertility.\u003c/p>\n\u003cp>“Women are already using these as fertility tests. Over the years, they’ve worked their way into being in the mainstream without evidence,” said Dr. Anne Steiner, a reproductive endocrinologist at the University of North Carolina and one of the study’s authors.\u003c/p>\n\u003cp>“As we get older, fertility becomes a giant egg-shaped question mark,” the company said in an August blog post announcing the test.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But the new study finds that looking at levels FSH, AMH, and inhibin B isn’t an answer to the question of fertility.\u003c/p>\n\u003cp>Steiner and her colleagues analyzed data from 750 women between ages 30 and 44 who didn’t have any known fertility problems, had been trying to get pregnant for three months or less, and lived with a male partner. Women who had lower levels of the biomarkers — indicating “diminished ovarian reserve” — weren’t any less likely to get pregnant in the first year than women who had higher levels of the biomarkers.\u003c/p>\n\u003cp>In other words, ovarian reserve tests run the risk of giving women an inaccurate impression of their future chances of having children.\u003c/p>\n\u003cp>“Women with low values are going to have unnecessary anxiety, and women with high values may be incorrectly reassured,” Steiner said. She added that women shouldn’t use the tests to decide whether to freeze their eggs.\u003c/p>\n\u003cp>The caveats: The outcome studied was getting pregnant, not carrying a healthy pregnancy fully to term. It also only followed women for the first year they were trying to get pregnant. And the researchers didn’t run any fertility tests on the partners of the women involved in the study — though Steiner pointed out that direct-to-consumer fertility tests only test women’s levels as well.\u003c/p>\n\u003cp>Dr. Stephen Collins of the Yale Fertility Center, who wasn’t affiliated with the study, said that with this evidence in hand, doctors and the makers of direct-to-consumer tests should be upfront about the evidence for FSH, AMH, and inhibin B tests to predict fertility in the short term.\u003c/p>\n\u003cp>“As practitioners, we need to recognize the limitations of the tests that we’re offering,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2017/10/10/ovarian-reserve-tests-fertility/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery. \u003c/span>\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"Tests that measure 'ovarian reserve' to estimate how many years of fertility women have left are increasingly popular. But a new study finds that levels of the hormones tested aren’t tied to lower chances of pregnancy.","status":"publish","parent":0,"modified":1508342957,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":645},"headData":{"title":"Popular Fertility Test Doesn't Work, Study Says | KQED","description":"Tests that measure 'ovarian reserve' to estimate how many years of fertility women have left are increasingly popular. But a new study finds that levels of the hormones tested aren’t tied to lower chances of pregnancy.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Popular Fertility Test Doesn't Work, Study Says","datePublished":"2017-10-17T21:43:48.000Z","dateModified":"2017-10-18T16:09:17.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"435969 https://ww2.kqed.org/futureofyou/?p=435969","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/10/17/ovarian-reserve-test-marketed-as-fertility-measure-doesnt-work-study/","disqusTitle":"Popular Fertility Test Doesn't Work, Study Says","nprByline":"Megan Thielking\u003cbr />\u003ca href=\"https://www.statnews.com/\">STAT\u003c/a>","path":"/futureofyou/435969/ovarian-reserve-test-marketed-as-fertility-measure-doesnt-work-study","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Tests that measure a woman’s “ovarian reserve” to estimate how many more years of fertility she has have grown increasingly popular. But a new study finds that levels of the hormones commonly tested aren’t tied to lower chances of getting pregnant.\u003c/p>\n\u003cp class=\"danger-zone\">The new research, published in the \u003cem>Journal of the American Medical Association\u003c/em>, looked at three markers: anti-Müllerian hormone (AMH), follicle-stimulating hormone (FSH), and inhibin B.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Women with low values are going to have unnecessary anxiety, and women with high values may be incorrectly reassured.'\u003ccite>Dr. Anne Steiner, University of North Carolina\u003c/cite>\u003c/aside>\n\u003cp>That’s led to a boom in ovarian reserve testing, both in the clinic and with direct-to-consumer tests from companies. One startup, Modern Fertility, is pre-selling a new $149 fertility test that measures FSH, AMH, and other fertility hormones. The company says physicians will tally all those measures up and calculate a “fertility score.” Previous research has correlated levels of the three hormones with the number of eggs a woman has in her ovaries — a measure known as “ovarian reserve.” Studies have suggested that information could be used to predict how well a woman will respond to in vitro fertilization. But in recent years, as more women are delaying pregnancy until later ages, ovarian reserve tests have begun to be used as a way to test for future fertility.\u003c/p>\n\u003cp>“Women are already using these as fertility tests. Over the years, they’ve worked their way into being in the mainstream without evidence,” said Dr. Anne Steiner, a reproductive endocrinologist at the University of North Carolina and one of the study’s authors.\u003c/p>\n\u003cp>“As we get older, fertility becomes a giant egg-shaped question mark,” the company said in an August blog post announcing the test.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But the new study finds that looking at levels FSH, AMH, and inhibin B isn’t an answer to the question of fertility.\u003c/p>\n\u003cp>Steiner and her colleagues analyzed data from 750 women between ages 30 and 44 who didn’t have any known fertility problems, had been trying to get pregnant for three months or less, and lived with a male partner. Women who had lower levels of the biomarkers — indicating “diminished ovarian reserve” — weren’t any less likely to get pregnant in the first year than women who had higher levels of the biomarkers.\u003c/p>\n\u003cp>In other words, ovarian reserve tests run the risk of giving women an inaccurate impression of their future chances of having children.\u003c/p>\n\u003cp>“Women with low values are going to have unnecessary anxiety, and women with high values may be incorrectly reassured,” Steiner said. She added that women shouldn’t use the tests to decide whether to freeze their eggs.\u003c/p>\n\u003cp>The caveats: The outcome studied was getting pregnant, not carrying a healthy pregnancy fully to term. It also only followed women for the first year they were trying to get pregnant. And the researchers didn’t run any fertility tests on the partners of the women involved in the study — though Steiner pointed out that direct-to-consumer fertility tests only test women’s levels as well.\u003c/p>\n\u003cp>Dr. Stephen Collins of the Yale Fertility Center, who wasn’t affiliated with the study, said that with this evidence in hand, doctors and the makers of direct-to-consumer tests should be upfront about the evidence for FSH, AMH, and inhibin B tests to predict fertility in the short term.\u003c/p>\n\u003cp>“As practitioners, we need to recognize the limitations of the tests that we’re offering,” he said.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>\u003cspan style=\"font-weight: 400\">This \u003ca href=\"https://www.statnews.com/2017/10/10/ovarian-reserve-tests-fertility/\" target=\"_blank\" rel=\"noopener\">story\u003c/a> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery. \u003c/span>\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435969/ovarian-reserve-test-marketed-as-fertility-measure-doesnt-work-study","authors":["byline_futureofyou_435969"],"programs":["futureofyou_54"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1"],"tags":["futureofyou_1275","futureofyou_283","futureofyou_1377","futureofyou_520"],"featImg":"futureofyou_436216","label":"futureofyou_54"},"futureofyou_435643":{"type":"posts","id":"futureofyou_435643","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435643","score":null,"sort":[1506927665000]},"guestAuthors":[],"slug":"pregnant-women-should-still-get-the-flu-vaccine-doctors-advise","title":"Pregnant Women Should Still Get The Flu Vaccine, Doctors Advise","publishDate":1506927665,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Flu symptoms can be more severe when you're pregnant, landing women in the hospital, threatening their lives and even leading to preterm birth or miscarriage. The virus is a risk to the woman and the baby.\u003c/p>\n\u003cp>So, it's particularly important that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26012384\">people who are pregnant get the flu vaccine\u003c/a>. And it's also important that the effects of those vaccines be studied in pregnant women.\u003c/p>\n\u003cp>But research doesn't always turn up the information you're expecting, which is what happened last week when a \u003ca href=\"https://www.ncbi.nlm.nih.gov/labs/articles/28917295/\">study\u003c/a> was published that found an association between the flu vaccine and early-term miscarriage in some women.\u003c/p>\n\u003cp>\"We knew this would be controversial when it was published. This was an unexpected safety signal. This is not what we were looking for,\" says one of the study's co-authors, epidemiologist \u003ca href=\"http://www.marshfieldresearch.org/profiles/4082\">Dr. Edward Belongia\u003c/a>. He directs the center for clinical epidemiology and population health at the Marshfield Clinic in Wisconsin, and is a member of the CDC's advisory committee on immunization practices.\u003c/p>\n\u003cp>\"I believe,\" Belongia says, \"the best approach with the public is to be very clear and open and transparent about 'Here's what we know; here are the limitations; here's why we still recommend the flu vaccine during pregnancy.' \"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[contextly_sidebar id=\"coCoO9PxYa1pgets8MuBrISD9dCWdBwL\"]The research followed up on a previous study, also led by Belongia and his team, that found the opposite result — no link between miscarriage and the flu vaccine. That study looked at women who were pregnant in 2005, 2006 and 2007 — before the 2009 H1N1 flu pandemic, which led to a new vaccine.\u003c/p>\n\u003cp>\"The CDC was very interested to make sure that we were still seeing the same safety profile for this new vaccine, and so asked us to do another study,\" explains lead author \u003ca href=\"http://www.marshfieldresearch.org/profiles/2327\">James Donahue\u003c/a>, a senior epidemiologist at the Marshfield Clinic. The new results look at women who were pregnant in 2010, 2011 and 2012, and find an association between the flu vaccine and miscarriage in the first trimester of pregnancy. The study does not establish a causal relationship between the two.\u003c/p>\n\u003cp>Miscarriage is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22511535\">very common during the first trimester\u003c/a>, although the exact rate is difficult to pin down because some women who miscarry very early may not ever know they are pregnant.\u003c/p>\n\u003cp>Belongia says that, despite the preliminary nature of the findings, his team had a scientific obligation to publish them. \"The scientific literature is littered with things that were found unexpectedly and were later found to be not important — or even not true — so we're very cognizant of that,\" he says. \"But this is a safety signal we can't explain away, and it clearly merits further investigation.\"\u003c/p>\n\u003cp>The American College of Obstetricians and Gynecologists agrees. After the new study was published, the organization released a \u003ca href=\"https://www.acog.org/About-ACOG/News-Room/Statements/2017/It-is-Safe-to-Receive-Flu-Shot-During-Pregnancy\">statement \u003c/a>reminding women and physicians that the flu vaccine is an \"essential element of prenatal care,\" noting that when administered during pregnancy, it protects both women and newborn babies. That protection is particularly important for newborns, since the flu vaccine is not approved for infants younger than six months.\u003c/p>\n\u003cp>\"These results are something we need to pay attention to and follow up on, but the overwhelming data supports the importance of vaccination,\" says \u003ca href=\"https://www.acog.org/About-ACOG/News-Room/News-Releases/2015/ACOG-Elects-New-VP\">Dr. Christopher Zahn\u003c/a>, ACOG's vice president of practice activities.\u003c/p>\n\u003cp>Pregnant women who are worried or confused about vaccination can get information at \u003ca href=\"http://www.immunizationforwomen.org/\">ACOG's website\u003c/a>, and should talk to their doctors, Zahn and the study authors agree.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's perfectly appropriate for any pregnant woman who hears about this and is concerned about this to talk to their obstetrician about the best timing for a vaccination based on her own circumstance,\" says Belongia.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pregnant+Women+Should+Still+Get+The+Flu+Vaccine%2C+Doctors+Advise&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Researchers and physicians say a study suggesting a link between the flu vaccine and miscarriage in a limited population is cause for more research, not a reason to change vaccination recommendations.","status":"publish","parent":0,"modified":1506452543,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":15,"wordCount":629},"headData":{"title":"Pregnant Women Should Still Get The Flu Vaccine, Doctors Advise | KQED","description":"Researchers and physicians say a study suggesting a link between the flu vaccine and miscarriage in a limited population is cause for more research, not a reason to change vaccination recommendations.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Pregnant Women Should Still Get The Flu Vaccine, Doctors Advise","datePublished":"2017-10-02T07:01:05.000Z","dateModified":"2017-09-26T19:02:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"435643 https://ww2.kqed.org/futureofyou/?p=435643","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/10/02/pregnant-women-should-still-get-the-flu-vaccine-doctors-advise/","disqusTitle":"Pregnant Women Should Still Get The Flu Vaccine, Doctors Advise","nprByline":"Rebecca Hersher\u003c/br>NPR Shots","nprImageAgency":"Katherine Streeter for NPR ","nprStoryId":"552668449","nprApiLink":"http://api.npr.org/query?id=552668449&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2017/09/25/552668449/pregnant-women-should-still-get-the-flu-vaccine-doctors-advise?ft=nprml&f=552668449","nprRetrievedStory":"1","nprPubDate":"Mon, 25 Sep 2017 07:39:00 -0400","nprStoryDate":"Mon, 25 Sep 2017 04:35:00 -0400","nprLastModifiedDate":"Mon, 25 Sep 2017 07:20:16 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2017/09/20170925_me_pregnant_women_should_still_get_the_flu_vaccine_doctors_advise.mp3?orgId=1&topicId=1128&d=133&p=3&story=552668449&t=progseg&e=553405702&seg=2&ft=nprml&f=552668449","nprAudioM3u":"http://api.npr.org/m3u/1553405861-0e2f63.m3u?orgId=1&topicId=1128&d=133&p=3&story=552668449&t=progseg&e=553405702&seg=2&ft=nprml&f=552668449","path":"/futureofyou/435643/pregnant-women-should-still-get-the-flu-vaccine-doctors-advise","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2017/09/20170925_me_pregnant_women_should_still_get_the_flu_vaccine_doctors_advise.mp3?orgId=1&topicId=1128&d=133&p=3&story=552668449&t=progseg&e=553405702&seg=2&ft=nprml&f=552668449","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Flu symptoms can be more severe when you're pregnant, landing women in the hospital, threatening their lives and even leading to preterm birth or miscarriage. The virus is a risk to the woman and the baby.\u003c/p>\n\u003cp>So, it's particularly important that \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/26012384\">people who are pregnant get the flu vaccine\u003c/a>. And it's also important that the effects of those vaccines be studied in pregnant women.\u003c/p>\n\u003cp>But research doesn't always turn up the information you're expecting, which is what happened last week when a \u003ca href=\"https://www.ncbi.nlm.nih.gov/labs/articles/28917295/\">study\u003c/a> was published that found an association between the flu vaccine and early-term miscarriage in some women.\u003c/p>\n\u003cp>\"We knew this would be controversial when it was published. This was an unexpected safety signal. This is not what we were looking for,\" says one of the study's co-authors, epidemiologist \u003ca href=\"http://www.marshfieldresearch.org/profiles/4082\">Dr. Edward Belongia\u003c/a>. He directs the center for clinical epidemiology and population health at the Marshfield Clinic in Wisconsin, and is a member of the CDC's advisory committee on immunization practices.\u003c/p>\n\u003cp>\"I believe,\" Belongia says, \"the best approach with the public is to be very clear and open and transparent about 'Here's what we know; here are the limitations; here's why we still recommend the flu vaccine during pregnancy.' \"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>The research followed up on a previous study, also led by Belongia and his team, that found the opposite result — no link between miscarriage and the flu vaccine. That study looked at women who were pregnant in 2005, 2006 and 2007 — before the 2009 H1N1 flu pandemic, which led to a new vaccine.\u003c/p>\n\u003cp>\"The CDC was very interested to make sure that we were still seeing the same safety profile for this new vaccine, and so asked us to do another study,\" explains lead author \u003ca href=\"http://www.marshfieldresearch.org/profiles/2327\">James Donahue\u003c/a>, a senior epidemiologist at the Marshfield Clinic. The new results look at women who were pregnant in 2010, 2011 and 2012, and find an association between the flu vaccine and miscarriage in the first trimester of pregnancy. The study does not establish a causal relationship between the two.\u003c/p>\n\u003cp>Miscarriage is \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/22511535\">very common during the first trimester\u003c/a>, although the exact rate is difficult to pin down because some women who miscarry very early may not ever know they are pregnant.\u003c/p>\n\u003cp>Belongia says that, despite the preliminary nature of the findings, his team had a scientific obligation to publish them. \"The scientific literature is littered with things that were found unexpectedly and were later found to be not important — or even not true — so we're very cognizant of that,\" he says. \"But this is a safety signal we can't explain away, and it clearly merits further investigation.\"\u003c/p>\n\u003cp>The American College of Obstetricians and Gynecologists agrees. After the new study was published, the organization released a \u003ca href=\"https://www.acog.org/About-ACOG/News-Room/Statements/2017/It-is-Safe-to-Receive-Flu-Shot-During-Pregnancy\">statement \u003c/a>reminding women and physicians that the flu vaccine is an \"essential element of prenatal care,\" noting that when administered during pregnancy, it protects both women and newborn babies. That protection is particularly important for newborns, since the flu vaccine is not approved for infants younger than six months.\u003c/p>\n\u003cp>\"These results are something we need to pay attention to and follow up on, but the overwhelming data supports the importance of vaccination,\" says \u003ca href=\"https://www.acog.org/About-ACOG/News-Room/News-Releases/2015/ACOG-Elects-New-VP\">Dr. Christopher Zahn\u003c/a>, ACOG's vice president of practice activities.\u003c/p>\n\u003cp>Pregnant women who are worried or confused about vaccination can get information at \u003ca href=\"http://www.immunizationforwomen.org/\">ACOG's website\u003c/a>, and should talk to their doctors, Zahn and the study authors agree.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\"It's perfectly appropriate for any pregnant woman who hears about this and is concerned about this to talk to their obstetrician about the best timing for a vaccination based on her own circumstance,\" says Belongia.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Pregnant+Women+Should+Still+Get+The+Flu+Vaccine%2C+Doctors+Advise&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435643/pregnant-women-should-still-get-the-flu-vaccine-doctors-advise","authors":["byline_futureofyou_435643"],"categories":["futureofyou_1"],"tags":["futureofyou_1275","futureofyou_662","futureofyou_664","futureofyou_520"],"featImg":"futureofyou_435644","label":"futureofyou"},"futureofyou_435547":{"type":"posts","id":"futureofyou_435547","meta":{"index":"posts_1591205157","site":"futureofyou","id":"435547","score":null,"sort":[1505977266000]},"guestAuthors":[],"slug":"xanax-or-zoloft-for-moms-to-be-a-new-study-assesses-safety","title":"Xanax Or Zoloft For Moms-To-Be: A New Study Assesses Safety","publishDate":1505977266,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Earlier this year, when Emily Chodos was about 25 weeks into her pregnancy, she woke up one night feeling horrible.\u003c/p>\n\u003cp>\"My hands were tremoring, my heart racing, \" recalls Chodos, who lives near New Haven, Conn. She couldn't take a deep breath. \"I'd never felt so out of control of my body.\"\u003c/p>\n\u003cp>She ended up paging her obstetrician's office at 4 a.m., and one of the midwives in the practice, after listening to her symptoms, said, \"It sounds like you're having a panic attack.\"\u003c/p>\n\u003cp>Chodos was advised to take an antianxiety medication — Xanax. \"I was afraid to take it, as a pregnant woman,\" Chodos says. But she was miserable, so eventually decided to take the medicine that night.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It's kind of a tricky balance,\" Yonkers says. \"People have this illness that they didn't ask for and don't want. They're really suffering.'\u003ccite>Kimberly Yonkers, psychiatrist and professor at Yale University.\u003c/cite>\u003c/aside>\n\u003cp>Chodos, who is a nurse, knew that there are concerns about drugs like Xanax and other medications its class-- benzodiazepines.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Studies completed decades ago suggested a risk of birth defects from these drugs, but data from more recent studies have shown\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/7881198\"> no clear evidence of an increase\u003c/a>. There are remaining questions, researchers say, about whether \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28746341\">prenatal exposure\u003c/a> to the drugs can influence behavior.\u003c/p>\n\u003cp>\"I felt very trapped,\" Chodos says. It felt as if there was probably no safe medication — \"that I'd probably just have to suffer and feel awful.\"\u003c/p>\n\u003cp>At her doctor's suggestion, Chodos went to see \u003ca href=\"https://publichealth.yale.edu/people/kimberly_yonkers.profile\">Dr. Kimberly Yonkers\u003c/a>, a psychiatrist and professor at Yale University. Yonkers has been studying the effects of benzodiazepines and \u003ca href=\"http://www.nhs.uk/conditions/SSRIs-(selective-serotonin-reuptake-inhibitors)/Pages/Introduction.aspx\">SSRI antidepressants\u003c/a> on the pregnancies of women who have anxiety, depression or panic disorders.\u003c/p>\n\u003cp>Yonkers told us she understands why women can feel torn about using these drugs when they're expecting.\u003c/p>\n\u003cp>\"It's kind of a tricky balance,\" Yonkers says. \"People have this illness that they didn't ask for and don't want. They're really suffering.\"\u003c/p>\n\u003cp>The medications can help them, but women worry about the potential risk to their baby's health.[contextly_sidebar id=\"RPshNuKSbaNAD09WDBT46ZXAdg4y4ysX\"]\u003c/p>\n\u003cp>To understand the risks better, Yonkers and her collaborators studied about 2,600 women during pregnancy and after childbirth. The results of her \u003ca href=\"http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2652968\">study\u003c/a> do point to some risks associated with the benzodiazepines.\u003c/p>\n\u003cp>For instance, she found an increase in C-section deliveries. Also, the babies of mothers taking these drugs were more likely to need extra oxygen or or other respiratory support after birth. (An additional six in every 100 babies needed that sort of support, the study found, compared to the babies of women who didn't take the drugs.)\u003c/p>\n\u003cp>\"We also found the duration of pregnancy was shortened by, on average, 3.6 days — so quite modest,\" Yonkers says.\u003c/p>\n\u003cp>Women who took antidepressants such as Zoloft, Paxil, or other SSRIs) also had their pregnancies shortened, but by less than two days, on average. And their babies were also more likely to require oxygen or other minor respiratory support/assistance after delivery.\u003c/p>\n\u003cp>So, while these medications are not risk-free, Yonkers says \"it should be reassuring that we're not seeing a huge magnitude of an effect here.\"\u003c/p>\n\u003cp>The study, \u003ca href=\"http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2652968\">published\u003c/a> this week in the journal \u003cem>JAMA Psychiatry\u003c/em>, also concludes that having a panic or anxiety disorder during pregnancy does not seem to be risky to the developing baby.\u003c/p>\n\u003cp>\"We found that the maternal illnesses of panic disorder and generalized anxiety disorder were not associated with preterm birth or low birth weight or some of the other complications to mother and her offspring,\" Yonkers says. \"So, that's really good news.\"\u003c/p>\n\u003cp>The bottom line, she says is that the findings suggest that women who need treatment for these disorders don't need to stop taking these medications during pregnancy.\u003c/p>\n\u003cp>There's still some uncertainty among practitioners and mothers-to-be about the use of anxiety and antidepressants in pregnancy, but some leading OBGYNs point out the benefits of being treated with the drugs.\u003c/p>\n\u003cp>\"I think that there are women who are in need of medication for mood disorders and/or psychiatric disorders during pregnancy,\" \u003ca href=\"http://www.stonybrook.edu/experts/profile/david-garry\">Dr. David Garry\u003c/a>, a maternal fetal medicine specialist at Stony Brook University tells us.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Pregnant women should consult with their health care providers, he says, and aim to take the lowest doses possible of the medications that are effective in treating their symptoms.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Xanax+Or+Zoloft+For+Moms-To-Be%3A+A+New+Study+Assesses+Safety&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Is it OK to take antidepressants or anxiety medicine during pregnancy? Recent research suggests women who need treatment can take these drugs. Doctors recommend the lowest effective dose.","status":"publish","parent":0,"modified":1505871039,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":749},"headData":{"title":"Xanax Or Zoloft For Moms-To-Be: A New Study Assesses Safety | KQED","description":"Is it OK to take antidepressants or anxiety medicine during pregnancy? Recent research suggests women who need treatment can take these drugs. Doctors recommend the lowest effective dose.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Xanax Or Zoloft For Moms-To-Be: A New Study Assesses Safety","datePublished":"2017-09-21T07:01:06.000Z","dateModified":"2017-09-20T01:30:39.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"435547 https://ww2.kqed.org/futureofyou/?p=435547","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/09/21/xanax-or-zoloft-for-moms-to-be-a-new-study-assesses-safety/","disqusTitle":"Xanax Or Zoloft For Moms-To-Be: A New Study Assesses Safety","nprByline":"\u003ca href=\"http://www.npr.org/people/2100208/allison-aubrey\">Allison Aubrey\u003c/a>\u003c/br>NPR Shots","nprImageAgency":"Hanna Barczyk for NPR","nprStoryId":"551020800","nprApiLink":"http://api.npr.org/query?id=551020800&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2017/09/18/551020800/xanax-or-zoloft-for-moms-to-be-a-new-study-assesses-safety?ft=nprml&f=551020800","nprRetrievedStory":"1","nprPubDate":"Tue, 19 Sep 2017 12:57:00 -0400","nprStoryDate":"Mon, 18 Sep 2017 05:04:00 -0400","nprLastModifiedDate":"Tue, 19 Sep 2017 12:57:25 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2017/09/20170918_me_xanax_or_zoloft_for_moms-to-be_a_new_study_assesses_safety.mp3?orgId=1&topicId=1128&d=198&p=3&story=551020800&t=progseg&e=551714797&seg=2&ft=nprml&f=551020800","nprAudioM3u":"http://api.npr.org/m3u/1551726564-888bbf.m3u?orgId=1&topicId=1128&d=198&p=3&story=551020800&t=progseg&e=551714797&seg=2&ft=nprml&f=551020800","path":"/futureofyou/435547/xanax-or-zoloft-for-moms-to-be-a-new-study-assesses-safety","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/me/2017/09/20170918_me_xanax_or_zoloft_for_moms-to-be_a_new_study_assesses_safety.mp3?orgId=1&topicId=1128&d=198&p=3&story=551020800&t=progseg&e=551714797&seg=2&ft=nprml&f=551020800","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Earlier this year, when Emily Chodos was about 25 weeks into her pregnancy, she woke up one night feeling horrible.\u003c/p>\n\u003cp>\"My hands were tremoring, my heart racing, \" recalls Chodos, who lives near New Haven, Conn. She couldn't take a deep breath. \"I'd never felt so out of control of my body.\"\u003c/p>\n\u003cp>She ended up paging her obstetrician's office at 4 a.m., and one of the midwives in the practice, after listening to her symptoms, said, \"It sounds like you're having a panic attack.\"\u003c/p>\n\u003cp>Chodos was advised to take an antianxiety medication — Xanax. \"I was afraid to take it, as a pregnant woman,\" Chodos says. But she was miserable, so eventually decided to take the medicine that night.\u003c/p>\n\u003caside class=\"pullquote alignright\">'It's kind of a tricky balance,\" Yonkers says. \"People have this illness that they didn't ask for and don't want. They're really suffering.'\u003ccite>Kimberly Yonkers, psychiatrist and professor at Yale University.\u003c/cite>\u003c/aside>\n\u003cp>Chodos, who is a nurse, knew that there are concerns about drugs like Xanax and other medications its class-- benzodiazepines.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Studies completed decades ago suggested a risk of birth defects from these drugs, but data from more recent studies have shown\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/7881198\"> no clear evidence of an increase\u003c/a>. There are remaining questions, researchers say, about whether \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28746341\">prenatal exposure\u003c/a> to the drugs can influence behavior.\u003c/p>\n\u003cp>\"I felt very trapped,\" Chodos says. It felt as if there was probably no safe medication — \"that I'd probably just have to suffer and feel awful.\"\u003c/p>\n\u003cp>At her doctor's suggestion, Chodos went to see \u003ca href=\"https://publichealth.yale.edu/people/kimberly_yonkers.profile\">Dr. Kimberly Yonkers\u003c/a>, a psychiatrist and professor at Yale University. Yonkers has been studying the effects of benzodiazepines and \u003ca href=\"http://www.nhs.uk/conditions/SSRIs-(selective-serotonin-reuptake-inhibitors)/Pages/Introduction.aspx\">SSRI antidepressants\u003c/a> on the pregnancies of women who have anxiety, depression or panic disorders.\u003c/p>\n\u003cp>Yonkers told us she understands why women can feel torn about using these drugs when they're expecting.\u003c/p>\n\u003cp>\"It's kind of a tricky balance,\" Yonkers says. \"People have this illness that they didn't ask for and don't want. They're really suffering.\"\u003c/p>\n\u003cp>The medications can help them, but women worry about the potential risk to their baby's health.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>To understand the risks better, Yonkers and her collaborators studied about 2,600 women during pregnancy and after childbirth. The results of her \u003ca href=\"http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2652968\">study\u003c/a> do point to some risks associated with the benzodiazepines.\u003c/p>\n\u003cp>For instance, she found an increase in C-section deliveries. Also, the babies of mothers taking these drugs were more likely to need extra oxygen or or other respiratory support after birth. (An additional six in every 100 babies needed that sort of support, the study found, compared to the babies of women who didn't take the drugs.)\u003c/p>\n\u003cp>\"We also found the duration of pregnancy was shortened by, on average, 3.6 days — so quite modest,\" Yonkers says.\u003c/p>\n\u003cp>Women who took antidepressants such as Zoloft, Paxil, or other SSRIs) also had their pregnancies shortened, but by less than two days, on average. And their babies were also more likely to require oxygen or other minor respiratory support/assistance after delivery.\u003c/p>\n\u003cp>So, while these medications are not risk-free, Yonkers says \"it should be reassuring that we're not seeing a huge magnitude of an effect here.\"\u003c/p>\n\u003cp>The study, \u003ca href=\"http://jamanetwork.com/journals/jamapsychiatry/article-abstract/2652968\">published\u003c/a> this week in the journal \u003cem>JAMA Psychiatry\u003c/em>, also concludes that having a panic or anxiety disorder during pregnancy does not seem to be risky to the developing baby.\u003c/p>\n\u003cp>\"We found that the maternal illnesses of panic disorder and generalized anxiety disorder were not associated with preterm birth or low birth weight or some of the other complications to mother and her offspring,\" Yonkers says. \"So, that's really good news.\"\u003c/p>\n\u003cp>The bottom line, she says is that the findings suggest that women who need treatment for these disorders don't need to stop taking these medications during pregnancy.\u003c/p>\n\u003cp>There's still some uncertainty among practitioners and mothers-to-be about the use of anxiety and antidepressants in pregnancy, but some leading OBGYNs point out the benefits of being treated with the drugs.\u003c/p>\n\u003cp>\"I think that there are women who are in need of medication for mood disorders and/or psychiatric disorders during pregnancy,\" \u003ca href=\"http://www.stonybrook.edu/experts/profile/david-garry\">Dr. David Garry\u003c/a>, a maternal fetal medicine specialist at Stony Brook University tells us.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Pregnant women should consult with their health care providers, he says, and aim to take the lowest doses possible of the medications that are effective in treating their symptoms.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2017 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Xanax+Or+Zoloft+For+Moms-To-Be%3A+A+New+Study+Assesses+Safety&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/435547/xanax-or-zoloft-for-moms-to-be-a-new-study-assesses-safety","authors":["byline_futureofyou_435547"],"categories":["futureofyou_1"],"tags":["futureofyou_1076","futureofyou_592","futureofyou_520"],"featImg":"futureofyou_435548","label":"futureofyou"},"futureofyou_231484":{"type":"posts","id":"futureofyou_231484","meta":{"index":"posts_1591205157","site":"futureofyou","id":"231484","score":null,"sort":[1472657407000]},"guestAuthors":[],"slug":"electronic-tattoos-could-keep-pregnant-moms-out-of-hospital","title":"'Electronic Tattoos' Could Monitor Pregnant Moms at Home","publishDate":1472657407,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>The \"electronic tattoo\" may sound like an attempt by Silicon Valley to encroach on one of the last few activities still requiring an actual human being.\u003c/p>\n\u003cp>But what the term actually refers to is a sensor that adheres like a Band-Aid to parts of your body in order to monitor vital signs like heart rate, blood pressure and breathing. Another name for the devices-- equally evocative--is \"smart skin.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Women experiencing complications of pregnancy could potentially stay out of the hospital and have their vital signs monitored at home.\u003c/aside>\n\u003cp>Researchers around the country are designing electronic tattoos, which look a bit like a child's sticker but come outfitted with wireless antennae.\u003c/p>\n\u003cp>“The patch is a medical adhesive with an electronic sensor that can measure biological information,” says Todd Coleman, a bioengineering professor at the University of California, San Diego. “It’s not a watch. It’s something you peel and stick and mount right on your body.\"\u003c/p>\n\u003cp>This could be a boon to pregnant women forced into hospital stays due to complications, Coleman says. \"In the case of a pregnant woman, she would put it right on her abdomen to track her pregnancy.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The device moves easily when you pull or push the skin, even on curved areas like someone's stomach or an infant's forehead. The electronic patch might flash green, yellow or red to alert mothers when their signals go awry, Coleman said.\u003c/p>\n\u003cp>In the video below, Coleman shows how electronic tattoos can help an expectant mother track fetal development or monitor a newborn's brain function.\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=bhKLz1boyyY\u003c/p>\n\u003cp>Engineers are also working on devices that will include a screen like those developed from University of Tokyo researchers.\u003c/p>\n\u003cp>\"The advent of mobile phones has changed the way we communicate, said Takao Someya, a University of Tokyo researcher who worked on the device, in an April \u003ca href=\"http://www.eurekalert.org/pub_releases/2016-04/uot-uom041216.phphttp://www.eurekalert.org/pub_releases/2016-04/uot-uom041216.php\" target=\"_blank\">press release\u003c/a>. \"While these communication tools are getting smaller and smaller, they are still discrete devices that we have to carry with us.\u003c/p>\n\u003cp>\"What would the world be like if we had displays that could adhere to our bodies and even show our emotions or level of stress or unease?\"\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=ItsO4J9E98g\u003c/p>\n\u003cp>Despite that potential, it's going to be awhile before electronic tattoos hit the commercial market -- the FDA will have to approve them for use. For now, in terms of pregnancy wearables, \u003ca href=\"http://bloom.life/#hello\" target=\"_blank\">Bloom Technologies\u003c/a> offers a silicon sensor that tracks the frequency and duration of contractions. The device is much larger than electronic tattoo prototypes, and Coleman predicts it will evolve into something much slimmer.\u003c/p>\n\u003cfigure id=\"attachment_946914\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-946914\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2016/08/Bloom-Day2-0131-020437-sq-1-800x800.jpg\" alt=\"Bloom Technologies Belli sensor to monitor pregnancy contractions. \" width=\"800\" height=\"800\">\u003cfigcaption class=\"wp-caption-text\">Bloom Technologies Belli sensor to monitor pregnancy contractions. (Bloom Technologies)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"Also known as 'smart skin,' these pliable sensors capture crucial health data like heart rate or brain activity through a tiny elastic sheath similar to a sticker. ","status":"publish","parent":0,"modified":1517014562,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":13,"wordCount":470},"headData":{"title":"'Electronic Tattoos' Could Monitor Pregnant Moms at Home | KQED","description":"Also known as 'smart skin,' these pliable sensors capture crucial health data like heart rate or brain activity through a tiny elastic sheath similar to a sticker. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"'Electronic Tattoos' Could Monitor Pregnant Moms at Home","datePublished":"2016-08-31T15:30:07.000Z","dateModified":"2018-01-27T00:56:02.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"231484 http://ww2.kqed.org/futureofyou/?p=231484","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/08/31/electronic-tattoos-could-keep-pregnant-moms-out-of-hospital/","disqusTitle":"'Electronic Tattoos' Could Monitor Pregnant Moms at Home","path":"/futureofyou/231484/electronic-tattoos-could-keep-pregnant-moms-out-of-hospital","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The \"electronic tattoo\" may sound like an attempt by Silicon Valley to encroach on one of the last few activities still requiring an actual human being.\u003c/p>\n\u003cp>But what the term actually refers to is a sensor that adheres like a Band-Aid to parts of your body in order to monitor vital signs like heart rate, blood pressure and breathing. Another name for the devices-- equally evocative--is \"smart skin.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">Women experiencing complications of pregnancy could potentially stay out of the hospital and have their vital signs monitored at home.\u003c/aside>\n\u003cp>Researchers around the country are designing electronic tattoos, which look a bit like a child's sticker but come outfitted with wireless antennae.\u003c/p>\n\u003cp>“The patch is a medical adhesive with an electronic sensor that can measure biological information,” says Todd Coleman, a bioengineering professor at the University of California, San Diego. “It’s not a watch. It’s something you peel and stick and mount right on your body.\"\u003c/p>\n\u003cp>This could be a boon to pregnant women forced into hospital stays due to complications, Coleman says. \"In the case of a pregnant woman, she would put it right on her abdomen to track her pregnancy.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The device moves easily when you pull or push the skin, even on curved areas like someone's stomach or an infant's forehead. The electronic patch might flash green, yellow or red to alert mothers when their signals go awry, Coleman said.\u003c/p>\n\u003cp>In the video below, Coleman shows how electronic tattoos can help an expectant mother track fetal development or monitor a newborn's brain function.\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/bhKLz1boyyY'\n title='//www.youtube.com/embed/bhKLz1boyyY'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Engineers are also working on devices that will include a screen like those developed from University of Tokyo researchers.\u003c/p>\n\u003cp>\"The advent of mobile phones has changed the way we communicate, said Takao Someya, a University of Tokyo researcher who worked on the device, in an April \u003ca href=\"http://www.eurekalert.org/pub_releases/2016-04/uot-uom041216.phphttp://www.eurekalert.org/pub_releases/2016-04/uot-uom041216.php\" target=\"_blank\">press release\u003c/a>. \"While these communication tools are getting smaller and smaller, they are still discrete devices that we have to carry with us.\u003c/p>\n\u003cp>\"What would the world be like if we had displays that could adhere to our bodies and even show our emotions or level of stress or unease?\"\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/ItsO4J9E98g'\n title='//www.youtube.com/embed/ItsO4J9E98g'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>Despite that potential, it's going to be awhile before electronic tattoos hit the commercial market -- the FDA will have to approve them for use. For now, in terms of pregnancy wearables, \u003ca href=\"http://bloom.life/#hello\" target=\"_blank\">Bloom Technologies\u003c/a> offers a silicon sensor that tracks the frequency and duration of contractions. The device is much larger than electronic tattoo prototypes, and Coleman predicts it will evolve into something much slimmer.\u003c/p>\n\u003cfigure id=\"attachment_946914\" class=\"wp-caption aligncenter\" style=\"max-width: 800px\">\u003cimg class=\"size-medium wp-image-946914\" src=\"http://ww2.kqed.org/science/wp-content/uploads/sites/35/2016/08/Bloom-Day2-0131-020437-sq-1-800x800.jpg\" alt=\"Bloom Technologies Belli sensor to monitor pregnancy contractions. \" width=\"800\" height=\"800\">\u003cfigcaption class=\"wp-caption-text\">Bloom Technologies Belli sensor to monitor pregnancy contractions. (Bloom Technologies)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/231484/electronic-tattoos-could-keep-pregnant-moms-out-of-hospital","authors":["11229"],"categories":["futureofyou_1"],"tags":["futureofyou_26","futureofyou_1030","futureofyou_80","futureofyou_520","futureofyou_1031","futureofyou_25"],"featImg":"futureofyou_234073","label":"futureofyou"},"futureofyou_13130":{"type":"posts","id":"futureofyou_13130","meta":{"index":"posts_1591205157","site":"futureofyou","id":"13130","score":null,"sort":[1436895286000]},"guestAuthors":[],"slug":"bay-area-scientists-develop-mini-human-heart-chamber-in-a-dish","title":"Bay Area Scientists Develop Mini Human Heart Chamber in a Dish","publishDate":1436895286,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Bay Area scientists have developed a new method to test drugs that are likely to be dangerous for pregnant women and cause heart defects in the fetus.\u003c/p>\n\u003cp>Researchers from UC Berkeley and the Gladstone Institutes, an affiliate of the University of California, San Francisco, grew beating heart tissue from stem cells -- essentially a mini human heart chamber in a dish. Stem cells have the potential to become any type of cell in the human body.\u003c/p>\n\u003cp>The researchers intend to use the system to screen medications intended for pregnant women to detect whether they will likely do any harm to the fetus. Among the most commonly-reported birth defects involve the heart.\u003c/p>\n\u003cp>Birth defects affect three percent of babies born in the United States every year, according to the Centers for Disease Control and Prevention. Birth defects are one of the most common causes of infant deaths.\u003c/p>\n\u003cp>[Watch the video below for a demo.]\u003c/p>\n\u003cp>In 2014, scientists in the UK developed a \u003ca href=\"http://www.theguardian.com/science/2014/feb/02/stem-cell-research-heart-disease-long-qt\">similar model\u003c/a> to convert skin cells into beating heart cells in a petri dish. Previously, doctors would have needed to surgically remove heart tissue from patients to test new treatments, which is invasive and not practical.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>It's still early days for the technology, but the Gladstone Institutes' Dr. Bruce Conklin said the researchers have already tested whether the system could detect any problems with the drug Thalidomide. Thalidomide was prescribed widely in the 1960s for morning sickness but was later withdrawn for causing thousands of birth defects.\u003c/p>\n\u003cp>The system proved effective in this early experiment. Normal doses of the drug led to myriad problems, such as lower heart beat rate, compared with heart tissue that had not been exposed to the drug.\u003c/p>\n\u003cp>\"Thalidomide was tested in animals,\" said Dr. Conklin, whose research specializes in human genetics that lead to cardiovascular diseases. \"If they had a human model system in the 1960s, they could have caught it.\"\u003c/p>\n\u003cp>Since the Thalidomide disaster, Dr. Conklin said it has been very difficult for pharmaceutical companies to get drugs approved for pregnant women. \"They are so cautious,\" he said. But artificially grown, in vitro, miniature organs -- known as \"organoids\" -- could prove effective as a means to test drugs for potential birth defects.\u003c/p>\n\u003cp>The researchers say that this technology may replace animal models. Today, researchers will dissect animals at different stages of development to study how organs form. But one of the many drawbacks to testing on animals is that a mouse or pig may respond differently to a drug than a human subject.\u003c/p>\n\u003cp>In the future, the researchers say the technology can be adapted to other human organs. Dr. Conklin said he expects that a similar model will benefit cancer patients, who experience cardiac issues as a side effect of medication.\u003c/p>\n\u003cp>The results of their research were published this week in the science journal \u003cem>Nature Communications\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>[youtube https://www.youtube.com/watch?v=18-qE1s-Kys]\u003c/p>\n\n","blocks":[],"excerpt":"Bay Area scientists have developed a human heart chamber out of stem cells to test drugs for pregnant women.","status":"publish","parent":0,"modified":1477280926,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":503},"headData":{"title":"Bay Area Scientists Develop Mini Human Heart Chamber in a Dish | KQED","description":"Bay Area scientists have developed a human heart chamber out of stem cells to test drugs for pregnant women.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Bay Area Scientists Develop Mini Human Heart Chamber in a Dish","datePublished":"2015-07-14T17:34:46.000Z","dateModified":"2016-10-24T03:48:46.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"13130 http://ww2.kqed.org/futureofyou/?p=13130","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/07/14/bay-area-scientists-develop-mini-human-heart-chamber-in-a-dish/","disqusTitle":"Bay Area Scientists Develop Mini Human Heart Chamber in a Dish","path":"/futureofyou/13130/bay-area-scientists-develop-mini-human-heart-chamber-in-a-dish","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Bay Area scientists have developed a new method to test drugs that are likely to be dangerous for pregnant women and cause heart defects in the fetus.\u003c/p>\n\u003cp>Researchers from UC Berkeley and the Gladstone Institutes, an affiliate of the University of California, San Francisco, grew beating heart tissue from stem cells -- essentially a mini human heart chamber in a dish. Stem cells have the potential to become any type of cell in the human body.\u003c/p>\n\u003cp>The researchers intend to use the system to screen medications intended for pregnant women to detect whether they will likely do any harm to the fetus. Among the most commonly-reported birth defects involve the heart.\u003c/p>\n\u003cp>Birth defects affect three percent of babies born in the United States every year, according to the Centers for Disease Control and Prevention. Birth defects are one of the most common causes of infant deaths.\u003c/p>\n\u003cp>[Watch the video below for a demo.]\u003c/p>\n\u003cp>In 2014, scientists in the UK developed a \u003ca href=\"http://www.theguardian.com/science/2014/feb/02/stem-cell-research-heart-disease-long-qt\">similar model\u003c/a> to convert skin cells into beating heart cells in a petri dish. Previously, doctors would have needed to surgically remove heart tissue from patients to test new treatments, which is invasive and not practical.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>It's still early days for the technology, but the Gladstone Institutes' Dr. Bruce Conklin said the researchers have already tested whether the system could detect any problems with the drug Thalidomide. Thalidomide was prescribed widely in the 1960s for morning sickness but was later withdrawn for causing thousands of birth defects.\u003c/p>\n\u003cp>The system proved effective in this early experiment. Normal doses of the drug led to myriad problems, such as lower heart beat rate, compared with heart tissue that had not been exposed to the drug.\u003c/p>\n\u003cp>\"Thalidomide was tested in animals,\" said Dr. Conklin, whose research specializes in human genetics that lead to cardiovascular diseases. \"If they had a human model system in the 1960s, they could have caught it.\"\u003c/p>\n\u003cp>Since the Thalidomide disaster, Dr. Conklin said it has been very difficult for pharmaceutical companies to get drugs approved for pregnant women. \"They are so cautious,\" he said. But artificially grown, in vitro, miniature organs -- known as \"organoids\" -- could prove effective as a means to test drugs for potential birth defects.\u003c/p>\n\u003cp>The researchers say that this technology may replace animal models. Today, researchers will dissect animals at different stages of development to study how organs form. But one of the many drawbacks to testing on animals is that a mouse or pig may respond differently to a drug than a human subject.\u003c/p>\n\u003cp>In the future, the researchers say the technology can be adapted to other human organs. Dr. Conklin said he expects that a similar model will benefit cancer patients, who experience cardiac issues as a side effect of medication.\u003c/p>\n\u003cp>The results of their research were published this week in the science journal \u003cem>Nature Communications\u003c/em>.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/18-qE1s-Kys'\n title='//www.youtube.com/embed/18-qE1s-Kys'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/13130/bay-area-scientists-develop-mini-human-heart-chamber-in-a-dish","authors":["3252"],"categories":["futureofyou_1062"],"tags":["futureofyou_519","futureofyou_138","futureofyou_66","futureofyou_279","futureofyou_80","futureofyou_520","futureofyou_113"],"featImg":"futureofyou_13148","label":"futureofyou"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? Each episode also includes a short fiction story generated by advanced AI GPT-4, serving as a thought-provoking springboard to speculate how humanity could leverage technology for good.","airtime":"SUN 2pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Possible-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.possible.fm/","meta":{"site":"news","source":"Possible"},"link":"/radio/program/possible","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/possible/id1677184070","spotify":"https://open.spotify.com/show/730YpdUSNlMyPQwNnyjp4k"}},"1a":{"id":"1a","title":"1A","info":"1A is home to the national conversation. 1A brings on great guests and frames the best debate in ways that make you think, share and engage.","airtime":"MON-THU 11pm-12am","imageSrc":"https://ww2.kqed.org/radio/wp-content/uploads/sites/50/2018/04/1a.jpg","officialWebsiteLink":"https://the1a.org/","meta":{"site":"news","source":"npr"},"link":"/radio/program/1a","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?s=143441&mt=2&id=1188724250&at=11l79Y&ct=nprdirectory","tuneIn":"https://tunein.com/radio/1A-p947376/","rss":"https://feeds.npr.org/510316/podcast.xml"}},"all-things-considered":{"id":"all-things-considered","title":"All Things Considered","info":"Every weekday, \u003cem>All Things Considered\u003c/em> hosts Robert Siegel, Audie Cornish, Ari Shapiro, and Kelly McEvers present the program's trademark mix of news, interviews, commentaries, reviews, and offbeat features. Michel Martin hosts on the weekends.","airtime":"MON-FRI 1pm-2pm, 4:30pm-6:30pm\u003cbr />SAT-SUN 5pm-6pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/All-Things-Considered-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.npr.org/programs/all-things-considered/","meta":{"site":"news","source":"npr"},"link":"/radio/program/all-things-considered"},"american-suburb-podcast":{"id":"american-suburb-podcast","title":"American Suburb: The Podcast","tagline":"The flip side of gentrification, told through one town","info":"Gentrification is changing cities across America, forcing people from neighborhoods they have long called home. Call them the displaced. Now those priced out of the Bay Area are looking for a better life in an unlikely place. American Suburb follows this migration to one California town along the Delta, 45 miles from San Francisco. But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. 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Hosts Ki Sung and Katrina Schwartz introduce listeners to educators, researchers, parents and students who are developing effective ways to improve how kids learn. We cover topics like how fed-up administrators are developing surprising tactics to deal with classroom disruptions; how listening to podcasts are helping kids develop reading skills; the consequences of overparenting; and why interdisciplinary learning can engage students on all ends of the traditional achievement spectrum. This podcast is part of the MindShift education site, a division of KQED News. KQED is an NPR/PBS member station based in San Francisco. You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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On Our Watch brings listeners into the rooms where officers are questioned and witnesses are interrogated to find out who this system is really protecting. Is it the officers, or the public they've sworn to serve?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/On-Our-Watch-Podcast-Tile-703x703-1.jpg","imageAlt":"On Our Watch from NPR and KQED","officialWebsiteLink":"/podcasts/onourwatch","meta":{"site":"news","source":"kqed","order":"1"},"link":"/podcasts/onourwatch","subscribe":{"apple":"https://podcasts.apple.com/podcast/id1567098962","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5ucHIub3JnLzUxMDM2MC9wb2RjYXN0LnhtbD9zYz1nb29nbGVwb2RjYXN0cw","npr":"https://rpb3r.app.goo.gl/onourwatch","spotify":"https://open.spotify.com/show/0OLWoyizopu6tY1XiuX70x","tuneIn":"https://tunein.com/radio/On-Our-Watch-p1436229/","stitcher":"https://www.stitcher.com/show/on-our-watch","rss":"https://feeds.npr.org/510360/podcast.xml"}},"on-the-media":{"id":"on-the-media","title":"On The Media","info":"Our weekly podcast explores how the media 'sausage' is made, casts an incisive eye on fluctuations in the marketplace of ideas, and examines threats to the freedom of information and expression in America and abroad. 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