Participants: Don Mackintosh (Host), Dr. Neil Nedley
Series Code: HFAL
Program Code: HFAL00233A
00:50 Hello and welcome to Health for A Lifetime.
00:52 Today, we're gonna talk about something that 00:54 maybe many of our viewers have experienced 00:57 and that is looking forward to that first baby. 01:00 Being excited about that new bundle of joy 01:02 that's coming into your home. 01:04 Sometimes people say, Why wait? 01:07 Maybe something should come early. 01:09 But, we're going to learn today that having a baby too soon 01:13 is really quite damaging, 01:14 and how to avoid that, if possible. 01:17 Talking with us today about that is Dr. Neil Nedley. 01:19 Welcome, Dr. Nedley. 01:20 Thank you. Good to be here. 01:22 You're a friend to this program. 01:24 Some may have just joined us, but many times, we've talked. 01:26 You're actually an internal medicine specialist. 01:29 You practice in Ardmore, Oklahoma. - Correct. 01:31 You see people that have just had babies? 01:35 Normally, it's a pediatric type person or an OB type doctor 01:39 that sees these types of people that have had 01:41 births where there's a premature birth. 01:44 But how would you as an internal medicine relate to this? 01:48 Well, I often see many of these pregnant women in my 01:52 internal medicine office because they have 01:54 internal medicine problems. - Okay. 01:56 And, of course, that increases the risk of premature births. 02:00 And so, we're trying to do everything possible to 02:03 prevent the premature delivery. 02:05 So, we want to get that mom healthy; 02:07 all the different things we'll talk that about today. 02:09 Now this is a concern 02:10 among researchers here in America, isn't it? 02:13 It is a concern. In fact, just very recent studies have shown 02:18 that it's a growing problem in America. 02:21 In fact, we have a graphic that illustrates 02:24 that US health leaders are trying to craft a blueprint on 02:28 how to cut the US premature birth rate. 02:32 The problem with it is that so many people, 02:36 so many kids are being born premature now 02:39 In fact, it's increased by 20 percent since 1990. 02:44 Half a million babies are born premature 02:47 in this country every year. 02:50 And that means before 37 weeks. 02:52 So it's not just one week premature 02:53 or two weeks premature. 02:54 To actually get the definition of prematurity 02:57 you have to be more than four weeks early. 03:00 And, if you are more than four weeks early, 03:03 that increases your risk of a host of problems later on. 03:07 I know this isn't part of it, but what about coming late? 03:09 Is that a problem, too? 03:11 Coming late can be a problem. 03:13 Particularly if it's over two weeks late. 03:15 In some studies, it can increase the risk of some problems 03:19 However, that is not near as common a problem in America 03:23 as coming early; which is the far more common problem. 03:26 So, when they come premature, there also is the problem of... 03:31 Is it something to do with weight? 03:33 It is. Actually, if they're coming premature, 03:38 there actually is low birth weight associated with that. 03:42 And when you have low birth weight 03:44 then that also increases your risk of a number of problems. 03:46 So, let's talk, then about premature 03:50 birth, but more prenatal influences. 03:55 What kind of things are influencing this? 03:59 Identifying those would be one thing. 04:02 It may be obvious how to avoid them if we just identify them. 04:06 But, let's talk about those. 04:07 Well, some of the prenatal influences that could lead to 04:10 premature birth are going to be smoking, drinking, 04:15 more in vitro fertilization. 04:18 That's one of the reasons why it's increased. 04:20 The in vitro fertilization; 04:23 particularly when you have multiple pregnancies. 04:25 That also increases the risk 04:27 that prematurity is going to come about. 04:29 So, how does that work with the in vitro fertilization? 04:32 Is it not as closely... 04:34 Is it not as firmly grounded there in the... 04:37 Why would that be premature? 04:40 Well, often they're using more than one sperm 04:45 and more than one egg to do the in vitro fertilizations 04:49 so they get a pregnancy. 04:51 And so, to increase the chance that they'll have a pregnancy 04:56 often there can be two or three babies born; four or five. 05:01 That's where you get the seven babies born, eight babies born. 05:06 And the more babies that are inside the womb 05:09 of course, the bigger that womb gets. 05:11 And the larger it gets, the greater the risk that it's gonna 05:15 try to expel those contents before it's time. 05:19 And then smoking and alcohol? 05:20 How does that cause premature? 05:22 Do you know the mechanism of that? 05:24 There have been studies in regards to the mechanism. 05:28 It's actually more than one mechanism. 05:30 There's over 2000 chemicals in cigarette smoke. 05:33 Some of those chemicals can actually 05:37 lead to uterine contractions; 05:39 can lead to decreased circulation of certain portions 05:42 of the uterus. 05:43 One of the reasons why fibroids of the uterus 05:46 also can increase the risk of premature delivery 05:49 because of the decreased circulation in that area 05:54 and smoking does affect the circulation. 05:56 So, I'm sure second hand smoke would as well. 05:58 Second hand smoke does, to a certain extent. 06:01 So, if you're not a smoker and you're carrying a baby 06:04 you don't want your husband to smoke around you either. 06:07 Okay. And then alcohol? 06:08 Yes. Alcohol also has a significant role to play. 06:12 Alcohol increases the risk of blood pressure problems. 06:15 A lot of people are unaware of the fact 06:17 that just two ounces of alcohol a day 06:19 is all it takes to raise a woman's blood pressure. 06:22 And when she increases her blood pressure 06:26 it increases the risk of premature delivery. 06:28 Okay, so, no smoking, no drinking and 06:33 then also watching this 06:35 fertility things in terms of in vitro fertilization. 06:41 What are some other causes of premature... 06:44 Well, maternal obesity. 06:45 Maternal obesity? 06:47 That's right. And so, when the woman is overweight, she 06:50 increases her risk of actually having an underweight baby. 06:55 How does that work? 06:56 Maternal obesity also increases the risk of high blood pressure. 07:00 And there's probably some other mechanisms involved, as well, 07:03 in that process. 07:05 We recommend, actually if someone is overweight and 07:09 they're having a baby they don't need to gain as much weight 07:14 as someone who is of normal weight. 07:17 In fact, a recent obstetrics task force looked at this 07:22 and a person who is obese at the time that they conceive 07:28 they really should only gain about 15 pounds 07:30 during their pregnancy or maybe a little more. 07:33 But certainly not the 25 pounds that's recommended 07:35 for someone who is of normal weight 07:38 at the time when they get pregnant. 07:40 Maybe there's not enough room in there for the baby. 07:42 They want to get it out of there. 07:44 Well, that could be part of it as well as we'd talked about 07:47 when there is more pressure 07:49 on that it does increase the risk of delivery. 07:53 I saw a CAT scan, not of the lady of course but 07:57 looking at the obesity of someone inside 08:00 we see someone obese outside. 08:01 Inside there's also a lot of adipose tissue in there. 08:05 A lot of adipose tissue in there, and 08:07 A lot of fat cells. Right. 08:08 And if you're wearing tight jeans on top of that 08:12 you've increased the pressure even more. 08:14 Baby says, Get me out of here. 08:16 Anything else then in terms of premature... 08:20 There are a host of factors that 08:22 increase the risk of premature delivery. 08:24 Diabetes is one of them. 08:26 And if the diabetes is not controlled in the mother. 08:30 And so checking for gestational diabetes, 08:33 checking those blood sugars, 08:34 getting on the right diet so the blood sugars don't go above 140 08:38 an hour after eating is an important step 08:41 in preventing a premature delivery. 08:43 We don't know why they come out early based on that. 08:46 It's just, we need to avoid it. 08:48 That's right. We need to avoid it. 08:49 So Diabetes, making sure that... 08:52 And this happens a lot. 08:53 When someone gets pregnant, it just kind of 08:55 puts them over the edge and they 08:56 get diabetes when they never had it before. 08:58 So they need to get checked. 08:59 If they have the gene for diabetes. 09:01 In other words, if their mother was a diabetic, or father. 09:04 Or maybe their mother and father aren't old enough 09:07 to get to diabetes yet. 09:08 But if they have the gene there, even among grandparents 09:11 that really increases their risk of gestational diabetes. 09:15 When you say they have the gene, 09:16 they shouldn't get genetic testing, they just know their 09:18 family history, is what you're talking about. 09:19 Yeah. If they know their family history. 09:21 If that is there... If they do get gestational diabetes 09:26 it is a true sign that 09:29 that mother does indeed have the gene. 09:31 And so that means she is going to develop 09:34 diabetes later on in life unless she stays normal weight, 09:38 stays lean, stays exercising and eats the right food 09:41 and even if you have the gene for diabetes 09:43 you'll never develop diabetes 09:45 if you're on an ideal lifestyle program. 09:47 Some other things that increase the risk. 09:51 Caffeine increases the risk. 09:54 A study by Yale University back in 2003 showed that if you 09:58 drink a 10 ounce glass or cup of coffee per day, 10:03 it does significantly increase the risk of preterm delivery 10:07 as well as low birth weight babies. 10:09 So just one cup of Starbucks or whatever it is.. 10:13 That's right. 10:14 That's not something someone who is 10:17 pregnant or thinking of getting pregnant 10:19 or trying to get pregnant should be drinking. 10:21 Exactly. 10:23 Was there any factor as to when 10:24 they drank that during the pregnancy 10:26 in terms of heightened risk or was it anytime? 10:28 Particularly in the first two trimesters 10:33 it increases the risk. 10:34 So at the time you get pregnant, that's a good time to... 10:38 Actually before you get pregnant... 10:41 If you're planning on getting pregnant 10:43 go through the caffeine withdrawal first. 10:45 You'll have headaches for a couple of days 10:47 but it'll be worth it in the long run. 10:49 So, basically everything you know to be bad, 10:52 stop doing it before you get pregnant. 10:54 Exactly. You would actually... 10:57 That way your dream can be fulfilled 10:59 of having the perfect baby. 11:01 Everyone wants to have the perfect baby 11:06 and there are ways actually of 11:08 greatly increasing your likelihood of having 11:11 that perfect baby. 11:12 Does age have anything to do with premature births? 11:15 Age of the mother? Yes. 11:17 It does. 11:18 Mothers who are over the age of 35 when they get pregnant 11:22 they have an increased risk of preterm delivery. 11:25 And even more vital than that is mothers 11:28 who are under the age of 16 11:30 have a significant risk of preterm delivery. 11:34 In other words, when you are over 35 11:40 are you saying don't try to have a baby? 11:43 No, I'm just telling you the statistics on that 11:47 that are associated with it. 11:48 I think if you're over the age of 35 11:51 you can still have babies. 11:52 In fact a recent study 11:54 showed that if you have a baby and you're aged 45 11:57 you're four times as likely to live to age 90. 12:03 People ought to be less risk of living to age 90 12:06 but there might be some sort of motivation 12:08 to see your kids and your grandkids grow up. 12:11 So having babies in 40's is okay, 12:13 but you would really need to have some close prenatal 12:16 follow-up. 12:18 You need to really do the prenatal exams. 12:20 in fact, that's one of the risks as well. 12:22 We're talking about risks of preterm delivery. 12:24 One of the risks is if that girl just doesn't see the doctor 12:27 as scheduled for her prenatal exams. 12:30 You do need to see your gynecologist 12:34 for those prenatal exams. 12:35 And then, of course, the ultrasounds need to be done 12:38 making sure that the baby 12:39 is developing normally and healthfully. 12:42 And if you do that over the age of 35, 12:44 I think your risk can be almost as low as someone who's 30. 12:48 Certainly it needs to be avoided under the age of 16. 12:52 So, I'm not gonna ask how old your wife is, 12:55 and I'm not gonna ask how old mine is. 12:56 But at some point, this might be good information for them 12:59 if they want to have another child. 13:00 Yeah, absolutely. 13:02 My wife did have a couple of babies after the age of 35. 13:08 One in her 40's. 13:11 They were very healthy, 13:13 but she also paid very close attention 13:15 to what I am talking about here today. 13:17 We're talking with Dr. Neil Nedley. 13:19 We're talking about prenatal influences. 13:21 When we come back, you may be saying well, 13:23 I see what I shouldn't do and maybe that seems... 13:26 that's interesting, but when we come back 13:29 you're gonna to see how important it really is. 13:31 What are the impacts on children. 13:35 When we come back, we'll take a closer look 13:38 not only at what the impact can be 13:40 but what we can do to avoid problems. 13:42 So join us when we come back. |
Revised 2014-12-17