Connect with us

News

Hospitals enhance care for babies exposed to substances in womb

Published

on

Providers at a US hospital have created a process for caring for women giving birth to babies exposed to substances like opioids in the womb.

The new approach, developed by a team at US hospital Oklahoma Children’s Hospital OU Health, will see providers surround mother and baby with the care they need in the hospital, at home and in their communities for the years to come.

The American Academy of Pediatrics granted funding to the University of Oklahoma for hospital providers to refine and improve the discharge process for mothers and babies with neonatal abstinence syndrome, also known as neonatal opioid withdrawal syndrome.

 

The project, called the Perinatal Health and Substance Use Quality Improvement Virtual Learning Collaborative, is helping establish best practices for this transition. Oklahoma Children’s Hospital is one of eight hospitals nationwide chosen for the programme.

Neonatal hospitalist Benazir Drabu, M.D. is associate professor of paediatrics at the OU College of Medicine and team leader for the project.

Drabu said: “We want to provide continuity of care for mom and baby.

“Care starts prenatally and goes through labour and delivery, and for this project, we are focusing on our discharge planning.

“This is work we are already doing, but participating in the collaborative will allow us to learn how to do it better.”

Babies born with neonatal abstinence syndrome may experience withdrawal from the drugs that crossed the placenta while in utero.

Symptoms include jitteriness, trouble sleeping, diarrhea, vomiting, poor appetite and, in severe cases, seizures. I

f symptoms can be managed in the Mother-Baby Unit, the health care team focuses on soothing techniques, feeding and sleep support.

If a higher level of care is required, including medications, the baby is transferred to the Neonatal Intensive Care Unit.

Once discharge is possible, it is essential to have a well-structured plan to ensure caregivers receive adequate guidance and support.

Mothers and babies affected by substance use usually stay in the hospital longer than the general population of birthing mothers.

When discharge approaches, an interdisciplinary team of physicians, nurses, social services providers, physical therapists and occupational therapists shifts its focus to keeping the family well-supported at home.

Soothing strategies used in the hospital are reinforced, including providing the family with a “sleep sack” that swaddles the baby and teaching them how to console a fussy baby.

Safe sleep at home is also emphasised. The team encourages caregivers to have a crib or “pack and play” instead of letting babies sleep with parents.

Neonatologist Patricia Williams, M.D. is associate professor of paediatrics at the OU College of Medicine and a co-leader of the project.

Williams said: “In many cases, families don’t have a separate place for the baby to sleep, so they put them in their own bed, which puts the baby at risk for an adverse event.”

Mothers are screened for depression and coached on successful breastfeeding.

The hospital team also aims to strengthen communication with primary care providers to ensure continuity of care.

Social service providers connect the family to community organisations, such as Sooner Start and Oklahoma Family Network, that provide everything from diapers to respite care to support groups.

In addition, families are referred to the Little STAR clinic for an appointment 30 to 90 days after hospital discharge.

Little STAR is a follow-up programme to the Substance Use Treatment and Recovery (STAR) prenatal clinic at OU Health.

Susan Redwine, M.D. is an assistant professor of paediatrics in the OU College of Medicine and co-leader of the project.

She said: “Studies have shown that babies who have prenatal substance exposure can have poor developmental outcomes, both cognitively and behaviorally.

“We want to prepare caregivers for that but also give them hope because there are clinics and programmes that can help.

Early intervention is so important, as is being non-judgmental. Our goal is to provide as much support as possible.”

When babies reach 1 year old, they qualify for services at OU’s Child Study Center, which continues developmental and behavioural support up to age 7.

Redwine said: “We want to be the bridge between the baby leaving the hospital and getting families into programmes at the Child Study Center.”

OU was previously part of a national effort to improve the care of babies exposed to substances in the womb with its participation in the “Eat, Sleep, Console” clinical trial funded by the National Institutes of Health.

The trial evaluated the “ESC” approach to caring for babies with neonatal abstinence syndrome.

ESC includes feeding babies every three hours around the clock to address the weight loss that often comes with substance exposure.

ESC also prioritises consoling and ensuring babies get adequate sleep. If a baby cannot be consoled within 10 minutes, medication may be considered.

The trial had good outcomes, including a shorter hospital stay and decreasing the likelihood the baby would need medication. ESC has now become the standard of practice.

Drabu said: “It gives us a sense of fulfillment to help these babies and their caregivers and to keep them together as much as possible.

“Sending them home happy and prepared is priceless.”

Insight

Common cancer marker may play active role in preventing the disease, study finds

Published

on

Ki-67, a protein used to measure tumour growth, may also help prevent chromosome errors that drive cancer, a study suggests.

The findings could change how scientists view Ki-67, a marker commonly used in breast cancer and other tumours to assess how quickly cancer cells are growing.

Researchers found the protein may help preserve genome stability by maintaining the structural integrity of centromeres, key parts of chromosomes that help ensure DNA is shared correctly during cell division.

The research was led by professor Paola Vagnarelli at Brunel University of London in collaboration with scientists at the University of Edinburgh and the Technical University of Berlin.

Professor Vagnarelli said: “Doctors already measure Ki-67 to see how aggressive a cancer might be. But our results suggest it is actually helping maintain genome stability.

“That means it may be more than a marker. It could potentially also be a therapeutic target.”

The study examined three proteins that attach to chromosomes during cell division and help rebuild the molecular system that tells each new cell what kind of cell it is.

Every human cell carries identical DNA. What makes a liver cell different from a brain cell is which genes are switched on and which are kept inactive.

When a cell divides, that entire system of switches must be rebuilt. The three proteins involved in this process were Ki-67, Repo-Man and PNUTS.

Vagnarelli’s team developed a method that individually removes each protein from a living cell at the precise point of division. Older techniques could not isolate that moment cleanly.

They found that cells rely on all three proteins to reset themselves after division, but each failed in a different way when removed.

Without PNUTS, gene activity spiralled out of control and thousands of genes switched on at once.

Without Repo-Man, cells escaped safety checkpoints that usually stop damaged or abnormal cells from continuing to divide.

“What we didn’t expect was how clean the separation was,” said Vagnarelli.

Each protein fails in its own specific way. There is no redundancy, no safety net. Which means there are three separate points at which this process can go wrong.

“When the system breaks down, cells can emerge with the wrong number of chromosomes. That condition, called aneuploidy, is seen in disorders such as Down syndrome and in many cancers.

“We also found that these chromosome errors can trigger inflammatory signals inside the cell.”

Aneuploidy means a cell has too many or too few chromosomes, which can disrupt normal growth and function.

Inflammatory signals are chemical messages that can make a cell behave as if it is responding to injury or infection.

“These cells behave almost as if they are under attack,” said Vagnarelli.

“The immune response switches on because the genome is unstable.

“That link between chromosome imbalance and inflammation could help explain patterns we see in several diseases.”

The researchers said the findings may help cancer scientists better understand how chromosome instability, loss of gene regulation and cells dividing before they are ready contribute to tumour growth.

They said understanding the normal machinery that prevents these errors may help researchers find ways to push cancer cells into making mistakes they cannot survive.

“We now have a clearer map of the machinery that resets the cell after division,” said Vagnarelli.

“That knowledge gives us a starting point for thinking about new therapeutic approaches.”

Continue Reading

Menopause

Abdominal obesity may lead to more severe menopause symptoms – study

Published

on

Abdominal obesity may lead to worse menopause symptoms, including forgetfulness, irritability and night sweats, a new study suggests.

The findings point to a possible link between fat stored around the waist and more severe midlife symptoms.

Researchers said waist-to-height ratio could help identify women who may benefit from more targeted support.

Dr Monica Christmas is associate medical director for The Menopause Society.

Christmas said: “Unintended weight gain during the menopause transition, especially in the midsection, is one of the most commonly reported complaints, with the most significant gains experienced in the years leading up to the final menstrual period and a couple of years after.

“This not only affects self-image but also imposes negative health risks and, as the study highlights, is associated with higher prevalence and severity of menopause symptoms.”

The study used data from more than 1,100 women who took part in the Study of Women’s Health Across the Nation.

Abdominal obesity is a build-up of fat around the waist. It often includes visceral fat, which is deep, active fat surrounding internal organs.

This type of fat releases inflammatory proteins and toxic fatty acids that can contribute to insulin resistance, cardiovascular disease, high blood pressure and a higher risk of some cancers.

Insulin resistance means the body does not respond properly to insulin, the hormone that helps control blood sugar.

The Menopause Society said abdominal obesity is estimated to affect more than 60 per cent of menopausal women.

As oestrogen levels fall during menopause, women tend to store more fat around the waist rather than the hips, even if their overall weight does not change.

The researchers noted that obesity patterns and menopause symptom burden can vary by region, but research into the effect of abdominal obesity on these symptoms remains limited.

They also said earlier studies have mainly looked at single symptoms, rather than how symptoms connect with each other.

In this study, researchers used network analysis, a method that looks at how symptoms are linked, to compare symptom patterns in women with and without abdominal obesity.

They identified abdominal obesity using waist-to-height ratios, which compare waist size with height and can be used as a simple measure of health risk linked to body fat around the middle.

The researchers concluded that women with abdominal obesity had both a higher prevalence and greater severity of a range of symptoms, as well as a distinct symptom network structure.

In particular, women with abdominal obesity reported a higher prevalence and greater severity of dizziness, hot flashes and night sweats than women without abdominal obesity.

Sleep disturbances and palpitations were also reported more often in women with abdominal obesity. Palpitations are feelings of a fast, fluttering or pounding heartbeat.

The researchers said assessment of abdominal obesity using waist-to-height ratios may help stratify women who are likely to benefit from targeted, network-based interventions rather than isolated symptom management.

Christmas said: “Educating women early about healthy lifestyle interventions to prevent midlife weight gain is key to improving mental and physical well-being during a tumultuous time frame.”

Continue Reading

News

Perimenopause may offer “window of opportunity” for heart disease prevention

Published

on

Perimenopause may offer a key window to spot heart disease risk earlier, with women in the transition twice as likely to have low heart health scores, new research suggests.

The findings suggest the transition to menopause could be an important time to reassess risk and prompt lifestyle changes.

Garima Arora is senior author of the study and professor of medicine in the division of cardiovascular disease at the University of Alabama at Birmingham.

Arora said: “Mid-life women should think of the perimenopausal period as a ‘window of opportunity.’

They should be proactive and not wait until they reach menopause to start checking their blood pressure, cholesterol and blood sugar levels.

“Women should talk with their health care team about their reproductive status and any changes they are experiencing. It may be the perfect time to get a baseline for their heart health.”

The analysis included 9,248 women aged 18 to 80 who took part in the National Health and Nutrition Examination Survey between 2007 and 2020.

Researchers used Life’s Essential 8, a heart health score developed by the American Heart Association. It measures diet, physical activity, tobacco use, sleep, blood pressure, cholesterol, body weight and blood sugar on a 100-point scale.

Median scores fell as women moved through reproductive stages, from 73.3 out of 100 in premenopausal women to 69.1 in perimenopausal women and 63.9 in postmenopausal women.

Among the individual Life’s Essential 8 measures, diet consistently had the lowest scores and continued to decline across all reproductive stages.

After accounting for age, perimenopausal women were twice as likely to have a low overall score as premenopausal women.

They were also 76 per cent more likely to have a low cholesterol score and 83 per cent more likely to have a low blood sugar score.

The researchers said fluctuations in oestrogen levels during perimenopause may contribute to lower cardiovascular health because they may affect cholesterol, insulin resistance, blood pressure and weight management.

Insulin resistance means the body does not respond properly to insulin, the hormone that helps control blood sugar.

Sleep duration scores remained high across all reproductive stages, despite perimenopausal women reporting difficulty sleeping, suggesting sleep quality may be more affected than sleep length.

Amrita Nayak, lead author of the study and research fellow in the division of cardiovascular disease at the University of Alabama at Birmingham, said the findings highlight a point where risk may begin to rise.

She said: “Our analysis highlights that perimenopause, women’s reproductive transition period to menopause, is the critical time when the increase in cardiovascular risk seems magnified.

“When we compared women’s LE8 scores to the premenopausal baseline, the perimenopausal group was the first to show a significant jump in the odds of having low heart health.”

Arora added that nutrition could be an important area for early intervention.

“Nutrition can be a central factor for early and proactive intervention.

“Focusing on heart-healthy habits early, especially getting regular exercise and following a healthy eating plan like the DASH diet with a focus on lowering salt can help improve cardiovascular health for perimenopausal women in the years to come.”

Stacey E. Rosen, volunteer president of the American Heart Association, who was not involved in the study, said the findings underline the need to consider women-specific risk factors across life stages.

“This research highlights yet another aspect of the unique factors that increase a woman’s risk of cardiovascular disease throughout the stages of her lifespan.

“Significant health changes during pregnancy, perimenopause and menopause make it particularly important to pay close attention to increases in health risk factors during those times.

“I encourage women to talk with their primary care and specialty health care teams to learn about early detection and modification of traditional and ‘female-specific’ risk factors.

“Women can take proven steps to improve their cardiovascular health at all ages.”

The researchers said the next step is to follow women over several years to track hormone levels and heart health, which may help clarify the long-term impact of perimenopause and how lifestyle changes could reduce risk.

Continue Reading

Trending

Copyright © 2025 Aspect Health Media Ltd. All Rights Reserved.