Miscarriage: Keep breaking the silence

Hope Ricciotti, MD
Hope Ricciotti, MD, Editor in Chief, Harvard Women's Health Watch

Many public figures have begun speaking up about their experiences with miscarriage. While it’s wonderful that they’re breaking the silence, a recent survey has revealed that the general public still has a lot of misconceptions about this surprisingly common event. Dr. Hope Ricciotti shares her reactions to the survey results, and her advice to women experiencing miscarriage.

Experts say no amount of alcohol is safe during pregnancy

Claire McCarthy, MD
Claire McCarthy, MD, Faculty Editor, Harvard Health Publications

Many women think an occasional drink during pregnancy poses no harm, but a recent report suggests that no amount of alcohol is safe for the developing fetus. Alcohol affects the development of many organs, most notably the brain. While fetal alcohol syndrome, the most severe form of alcohol-induced damage, is unlikely to result from an occasional drink, researchers are finding that smaller amounts of alcohol can still have a negative effect. For that reason, no alcohol at all is safest when you’re pregnant or plan to conceive. If you’d like help cutting back on alcohol, don’t be embarrassed to talk with your doctor about it—she or he can help.

Treating unexplained infertility: Answers still needed

Jeffrey Ecker, MD
Jeffrey Ecker, MD, Contributing Editor

One of the most common treatments for unexplained infertility is ovulation induction, in which a woman takes drugs that will increase the number of eggs the ovary releases in the hope that at least one will result in a pregnancy. But when too many eggs are available for fertilization, the rates of high-risk multiple pregnancies go up. A recent study compared three drugs used for ovulation induction and found that the one more likely to result in a live birth was also more likely to result in a multiple pregnancy (twins, triplets, or more). The options for treating unexplained infertility remain less than ideal, but careful choices mean that the pregnancies that do result will be safer for moms and babies.

Number of babies born in withdrawal from prescription painkillers is on the rise

Claire McCarthy, MD
Claire McCarthy, MD, Faculty Editor, Harvard Health Publications

Each year, an alarming number of babies born in the United States spend their first few days withdrawing from drugs, often prescription painkillers their mothers took during their pregnancies. This problem, called neonatal abstinence syndrome (NAS), has increased fourfold since 2004, according to a report published online yesterday in The New England Journal of Medicine. NAS occurs in many babies whose mothers took a type of medication called an opioid during pregnancy. (Two commonly used opioids are OxyContin and Vicodin.) These drugs easily pass from the mother’s bloodstream to the baby’s. In effect, NAS is a baby’s withdrawal from opioids. With medication and time, babies with NAS get better, but they have to spend time in the hospital. In short, they get a rough start on life that can set them back and possibly have long-term repercussions. With so many safe options for pain control, women who are pregnant should use opioids only if these medications are absolutely necessary.

Pregnancy-related high blood pressure, diabetes linked to later heart disease

Howard LeWine, M.D.
Howard LeWine, M.D., Chief Medical Editor, Internet Publishing, Harvard Health Publications

Most of the changes that come with pregnancy—growing a belly “bump,” being tired, mood swings, cravings for particular foods, and the like—are normal, temporary, and harmless. Two other changes, pregnancy-related high blood pressure and diabetes, may have long-lasting implications for heart health. The development of high blood pressure during pregnancy is known as preeclampsia; pregnancy-related diabetes is called gestational diabetes. They are different from “regular” high blood pressure and diabetes because both are “cured” by delivery. A new study published this week in the journal Circulation suggests that these complications boost a woman’s risk of cardiovascular disease during middle age.