PEDIATRIC NEWS UPDATE NOVEMBER 2002

New Benefit Found for Folic Acid Supplements During Pregnancy
Researchers at Boston University found in a survey of 2000 women who were recently pregnant that those who took prenatal vitamins with folic acid had half the incidence of high blood pressure during their pregnancy. High blood pressure during pregnancy is part of the condition called preeclampsia which affects about 10% of first pregnancies and can cause complications in the mother and infant. It is not known, however, if this benefit was from the folic acid or another component of the prenatal vitamins. Folic acid has been shown to reduce homocysteine levels, a substance known to contribute to high blood pressure.

 

Dr. Sears comments: folic acid is now a routine recommendation for pregnant women, and for women who are planning to become pregnant, in order to reduce the risk of certain birth defects. If further research confirms this added benefit for blood pressure, folic acid would become even more important.

Folic Acid Important for Overall Cardiovascular Health
British researchers reported recently that a large review of current research on folic acid demonstrated that daily intake of at least 0.8 mg would decrease the risk of heart disease, strokes, and blood clots. Folic acid's effect on homocysteine is felt to be the reason for this benefit.

Dr. Sears comments: every day, new research shows how certain vitamins and minerals have a profound impact on our health. This recent folic acid research is only a drop in the bucket. That's why I am a firm believer in daily fruit and vegetable supplements. Click here for more information on how nutrition can improve your health.

Research Shows Importance of Bike Helmet Laws
A Canadian study showed that the Canadian Provinces that passed mandatory bike helmet laws showed a 45% decline in hospital admissions for head injuries due to bike accidents. The Provinces without a bike helmet law only showed a 27% decline in head injuries during the same 3 year period. This helps reinforce the importance of wearing a helmet AT ALL TIMES when riding a bike.

Dr. Sears comments: this is an area I feel parents need to be more strict about with their kids.

New Warning About Taking Paxil During Pregnancy
Paxil has been one of the most popular antidepressants over recent years, and has been thought to be safe enough to take during pregnancy. There have been recent reports of newborns experiencing jitteriness and excessive crying when moms used Paxil during pregnancy. This is thought to be due to withdrawal from the drug when the infant is born. Researchers at the University of Toronto recently reported results of a very small study of 55 women who took Paxil during the 3rd trimester of their pregnancy. At birth, their babies experienced more breathing and low blood sugar problems compared to a group of 54 babies whose moms either took Paxil only during the 1st or 2nd trimester, or not at all. All these newborn complications resolved within 1 to 2 weeks with no lasting effects. The 3rd trimester Paxil group also had a much higher incidence of premature delivery.

Dr. Sears comments: There are two very important points here:

1. Depression is a serious illness, and proper treatment is important. For those taking Paxil during pregnancy, abruptly stopping the medication can create withdrawal symptoms and make the depression worse. No antidepressant medication should be stopped without first consulting the doctor. Women with depression during pregnancy are at a higher risk of postpartum depression.
2. This is a very small study, and therefore the results are not as reliable. However, it does question the safety of Paxil during the 3rd trimester of pregnancy. The researchers of the study do not conclude that Paxil is unsafe, but do suggest that infants be observed more closely after birth, and that early discharge from the hospital for such mother/infant pairs may not be advisable. It appears that the cause of the newborns' distress may be due to withdrawal from the mother's Paxil at the time of birth, and not due to the medication itself. Consult with your OB if you are currently taking Paxil and are pregnant.

For a full discussion on postpartum depression and treatment options, click here

Debate Over Mercury in Fish Continues
The American Heart Association re-stated its recommendation this month that people should eat 2 servings of fish each week in order to get enough omega-3 fats in their diet. These healthy fats can decrease the chance of heart disease. However, a research study published this month has shown a possible link between mercury levels and heart attacks. It has recently become known that certain fish, especially shark, swordfish, king mackerel, and tilefish may be contaminated with mercury, and the FDA recommended limiting intake of these fish. Salmon, on the other hand, has been shown to be safe, and incidentally has the highest levels of healthy omega-3 fats of most fish. Another recent small study in San Francisco revealed that randomly sampled adults had blood mercury levels higher than FDA standard safety levels. The highest levels were found in people who routinely ate swordfish. Blood levels decreased significantly when fish was taken out of their diet.

Dr. Sears comments: We know that fish is the healthiest source of DHA and other omega-3 fats, and that these help prevent heart disease. We also know that fish can be contaminated with mercury. I suggest avoiding the four fish that the FDA has cautioned about, and eat salmon several times each month. DHA and other omega-3 supplements are also available. Click here to read more about these healthy fats.