The Thin End

Women taking antidepressants can be faced with a difficult choice when pregnant.  Many women are reluctant to take medication during pregnancy and feel the need to choose ‘between the drug and the baby’. Data shows that the majority of women stop taking such medicines abruptly on becoming pregnant.  But is this the best approach, particularly when the majority (70%) will relapse on stopping the medication?   So, should women stop taking the medication on becoming pregnant?  Certainly, there isn't a 'one size fits all solution'.  But women need to be supported in whatever decision is made.  This is why professional bodies such as  The Royal College of Obstetricians and Gynaecologists (RCOG) in the UK  recommend a pregnancy management plan worked up for an individual with a multidisciplinary support team.  We need more understanding of the mental health issues involved in a pregnancy.  The consequences of stopping medication can ...

A new study suggests that the dramatic fall in stillbirths is not due to the adoption of new growth assessement protocols in pregnancy. In 2015, the Secretary of State for Health in the UK announced a national ambition to halve the rates of stillbirths, neonatal and maternal deaths and brain injuries at birth by 2030, with a 20% reduction by 2020. The target is well on track to be met.  But what lies behind its success.  It was thought that it was the result of new protocols for assessing the growth of the baby in the womb. By comparing the growth of the fetus with expected growth for gestational age can indicate if something is going wrong.  For this vital assessment, growth charts are used.  The problem with the older growth charts was that they took no account of heterogeneity in the population.  More accurate growth assessment could save the lives of babies if problems could be detected sufficiently early in pregnancy. One approach in recent years...

There are still too many avoidable stillbirths, baby deaths and brain injuries that occur during term labour in the United Kingdom finds the latest report from Each Baby Counts . Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, says of the report: “There are still too many avoidable baby deaths and brain injuries occurring during term birth in the UK – even one preventable case is one too many. We owe it to each and every one affected to find out why these deaths and harms occur, in order to prevent future cases where possible." Launched in 2014 by the Royal College of Obstetricians and Gynaecologists, Each Baby Counts is a national quality improvement programme that aims to reduce the number of babies who die or are left severely disabled as a result of incidents that happen during term labour. The programme brings together the results of local maternity investigations into stillbirths, neonatal deaths and brain injuries to understand ...

The creation of genetically-modified babies is not only ethically justifiable but “highly desirable”, according to new academic research from a leading UK bioethicist. Dr Kevin Smith from Abertay University in Dundee, Scotland, has published ethical analysis concluding that the risks of gene editing are now low enough to justify its use with human embryos, with a view to producing genetically-modified (GM) people. In the paper, published in medical ethics journal Bioethics , Dr Smith argues that an ethically sound attempt could be less than two years away, and predicts such research could kick-start a revolution in human genetic modification. It is difficult to see what the nature of this research would be.  The problem does not lie in the ethics of 'designer babies', but in the possible complications of such research.  This is the point I and my colleagues made in a paper we published a few years ago.  Genes are rarely specific for a given characteristic.  ...

High maternal levels of the stress hormone cortisol during pregnancy increase the prevalence of anxious and depressive-like behaviour in female offspring assessed at the age of two.  This is the finding of a new study in the journal Biological Psychiatry. Effects of cortisol on the developing brain The effect of elevated maternal cortisol appeared to result from stronger communication between brain regions involved in sensory and emotion processing.  But this effect was seen only in female offspring and not in boys. Over the last two decades, studies have demonstrated the importance of the environment in the womb in health and disease in later life.  Programming of the brain is not gene-centred but critically dependent on conditions during pregnancy and in early postnatal life.   The findings of this new study show again the role of prenatal conditions in developing later susceptibility to mental health problems in offspring.   It also demon...