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Can a mother somehow positively affect fetus during pregnancy?

Can a mother somehow positively affect fetus during pregnancy?



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My mother keeps telling me that I like to study and have a predisposition to it because she was a student when she was pregnant. I highly doubt it, because I can't find any logic in these words.

I heard that a lot of mothers try to do something to positively affect their fetuses. For example:

  1. Listening to classical music.
  2. Learning something.
  3. Singing or playing musical instruments.

Can these activities somehow affect a child or is it just a myth?


HIV/AIDS in pregnant women and infants

Human immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the virus attacks and weakens the immune system. As the immune system weakens, the person is at risk of getting life-threatening infections and cancers. When that happens, the illness is called AIDS.

HIV can be transmitted to the fetus or the newborn during pregnancy, during labor or delivery, or by breastfeeding.

This article is about HIV/AIDS in pregnant women and infants.


Hypothyroidism During Pregnancy

The symptoms of hypothyroidism are often subtle. They can mimic the symptoms of many other conditions and are often attributed to aging. People with mild hypothyroidism may have no signs or symptoms, which generally become more obvious as the condition worsens.

Common symptoms and signs include the following:

  • Fatigue,
  • Depression,
  • Modest weight gain,
  • Cold intolerance,
  • Excessive sleepiness,
  • Dry, coarse hair,
  • Hair loss.

What is hypothyroidism?

    is particularly common in women of child-bearing age.
  • As a result, it is no surprise that thyroid disease may complicate the course of pregnancy.
  • Frequency varies among different populations and different countries. While pregnancy itself is a natural state and not a "disease," thyroid disorders during pregnancy affect both the mother and baby.
  • This article focuses specifically on hypothyroidism and pregnancy. After a general description of normal and abnormal thyroid function, recent data on long term consequences in children of mothers who had hypothyroidism during pregnancy will be reviewed.

What is the thyroid gland? Where is it located and what does it do?

The thyroid is a gland weighing about 15 grams (about half an ounce) that is located in the front of the neck just below the Adam's apple (cricoid cartilage). The thyroid gland is responsible for the production of the body's thyroid hormone. The thyroid responds to hormonal signals from the brain to maintain a constant level of thyroid hormone. The hormone signals are sent by specialized areas of the brain (hypothalamus and pituitary gland), eventually sending thyroid stimulating hormone (TSH) that stimulates thyroid hormone production by the thyroid gland.

IMAGES

What are the signs and symptoms of thyroid disease? What causes it?

Disease of the thyroid gland is extremely common. In some conditions, the thyroid may produce too much hormone. In other conditions, the thyroid may be damaged or destroyed and little, if any, thyroid hormone is produced. The main thyroid hormone is called thyroxine, or T4.

Symptoms of thyroid problems vary depending on whether there is too much or too little T4 present in the blood. With an excess of T4 (hyperthyroidism), people may complain of feeling:

Some people may have symptoms like:

If T4 levels are low (hypothyroidism) as a result of decreased production by the thyroid gland, patients often experience fatigue, lethargy, and weight gain. Constipation is common and many patients report feeling excessively cold.

How is hypothyroidism treated during pregnancy?

In many respects, the treatment of hypothyroidism in pregnant women is similar to that in nonpregnant women. A synthetic form of T4 is given to replace the missing hormone. The medication dose is regularly adjusted to maintain a steady blood level of thyroid hormone within the normal range, and the requirements for this hormone may increase during pregnancy. Therefore, it is routine practice to monitor the blood level of the thyroid stimulating hormone (TSH) during pregnancy. For more information, please read the article on hypothyroidism.

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Does hypothyroidism during pregnancy hurt the fetus?

Doctors have known for years of a link between mothers with untreated severe hypothyroidism during pregnancy and developmental delay in their children after birth. This was particularly seen in mothers who came from iodine deficient areas of the country (iodine is necessary to produce thyroid hormone and is now a common component of the salt in our foods), and was observed in mothers with autoimmune thyroid disease, such as Hashimoto's thyroiditis. Some studies have suggested that mild untreated hypothyroidism may also affect the baby&rsquos brain development, but this relationship is less clear.

How early does the mother's thyroid hormone affect the unborn baby?

Before birth a baby is entirely dependent on the mother for thyroid hormone until the baby's own thyroid gland can start to function. This usually does not occur until about 12 weeks of gestation (the end of the first trimester of pregnancy). Thus, hypothyroidism of the mother may play a role early on, before many women realize they are pregnant! In fact, the babies of mothers who were hypothyroid in the first part of pregnancy, then adequately treated, exhibited slower motor development than the babies of normal mothers. However, during the latter part of pregnancy, severe, untreated hypothyroidism in the mother can also have adverse effects on the baby, as pointed out by the research described above. These children are more likely to have intellectual impairment.

SLIDESHOW

How can you avoid the complications of hypothyroidism in pregnancy?

A number of medical associations and organizations have made recommendations on screening for thyroid disease. Some of the recommendations are:

  • All women who are planning a pregnancy should be considered for screening of thyroid disease.
  • All pregnant women with a goiter (enlarged thyroid), high blood levels of thyroid antibodies, a family history of thyroid disease, or symptoms of hypothyroidism should be tested for hypothyroidism.
  • In women who are borderline, or sub-clinical, hypothyroid (for example, not in the laboratory range for true hypothyroidism, but within the low normal range) and who also have positive antibodies (which may indicate an ongoing autoimmune thyroid destruction), therapy with low dose thyroid hormone at the onset of pregnancy may be beneficial.
  • There is some evidence that the antibodies that may contribute to hypothyroidism can play a role in pregnancy. Some data suggest that selenium supplementation may be of benefit in women with high antibody levels at the time of preconception. This should be reviewed with your doctor.
  • Women who are on thyroid hormone replacement before pregnancy should also be tested to make certain that their levels are appropriate. During pregnancy, the medication dose required may increase by up to 50%. Increases may be required as early as in the first trimester.
  • Dosing is dynamic during pregnancy and should be closely monitored by regular blood testing. As the pregnancy progresses, many women require higher doses of hormone replacement.
  • The dosage of thyroid hormone replacement during and after pregnancy should be carefully monitored using the blood thyroid stimulating hormone (TSH) value. The laboratory ranges for normal TSH are quite wide
  • In women with hypothyroidism before conception, most go back to their pre-pregnancy dose of thyroid hormone within a few weeks to months after delivery.

The management of each woman's situation is considered individually after consultation with her physician. The benefits of treatment extend not only to pregnant women with hypothyroidism, but also to their children.

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STDs during Pregnancy - CDC Fact Sheet (Detailed)

Detailed fact sheets are intended for physicians and individuals with specific questions about sexually transmitted diseases. Detailed fact sheets include specific testing and treatment recommendations as well as citations so the reader can research the topic more in depth.

A critical component of appropriate prenatal care is ensuring that pregnant patients are tested for STDs. Test your pregnant patients for STDs starting early in their pregnancy and repeat close to delivery, as needed. To ensure that the correct tests are being performed, we encourage you to have open, honest conversations with your pregnant patients and, when possible, their sex partners about symptoms they have experienced or are currently experiencing and any high-risk sexual behaviors in which they engage. The table below includes CDC&rsquos screening recommendations for pregnant women.

Risk Factors:

  • New or multiple sex partners
  • Sex partner with concurrent partners
  • Sex partner who has a sexually-transmitted disease (STD)

NOTE: Pregnant women found to have chlamydial infection should have a test-of-cure three to four weeks after treatment and then be retested within three months.

Risk factors:

  • Living in a high-morbidity area
  • Previous or coexisting STI
  • New or multiple sex partners
  • Inconsistent condom use among persons not in mutually monogamous relationships
  • Exchanging sex for money or drugs
  • At high risk for syphilis,
  • Who live in areas with high numbers of syphilis cases, and/or
  • Who were not previously tested, or had a positive test in the first trimester.

Risk Factors:

  • Having had more than one sex partner in the previous six months
  • Evaluation or treatment for an STD
  • Recent or current injection-drug use
  • An HBsAg-positive sex partner
  • Past or current injection-drug use
  • Having received a blood transfusion before July 1992
  • Receipt of unregulated tattoo
  • Long-term dialysis
  • Known exposure to HCV

As a provider working with pregnant patients, it is important for you to know the ways in which each STD can impact a woman and her developing baby. The following sections provide details on the effects of specific STDs during a woman&rsquos pregnancy, as well as links to Web pages with additional information.

Bacterial Vaginosis

Bacterial vaginosis (BV), a common cause of vaginal discharge in women of childbearing age, is a polymicrobial clinical syndrome resulting from a change in the vaginal community of bacteria. Although BV is often not considered an STD, it has been linked to sexual activity. Women may have no symptoms or may complain of a foul-smelling, fishy, vaginal discharge. BV during pregnancy has been associated with serious pregnancy complications, including premature rupture of the membranes surrounding the baby in the uterus, preterm labor, premature birth, chorioamnionitis, as well as endometritis. 8 While there is no evidence to support screening for BV in pregnant women at high risk for preterm delivery, 21 symptomatic women should be evaluated and treated. There are no known direct effects of BV on the newborn.

Chlamydia

Chlamydia is the most common sexually-transmitted bacterium in the United States. 4 Although the majority of chlamydial infections (including those in pregnant women) do not have symptoms, infected women may have abnormal vaginal discharge, bleeding after sex, or itching/burning with urination. Untreated chlamydial infection has been linked to problems during pregnancy, including preterm labor, premature rupture of membranes, and low birth weight. 5 The newborn may also become infected during delivery as the baby passes through the birth canal. Exposed newborns can develop eye and lung infections.

Gonorrhea

Gonorrhea is a common STD in the United States. Untreated gonococcal infection in pregnancy has been linked to miscarriages, premature birth and low birth weight, premature rupture of membranes, and chorioamnionitis. 6 Gonorrhea can also infect an infant during delivery as the infant passes through the birth canal. If untreated, infants can develop eye infections. Because gonorrhea can cause problems in both the mother and her baby, it is important for providers to accurately identify the infection, treat it with effective antibiotics, and closely follow up to make sure that the infection has been cured.

Hepatitis B

Hepatitis B pdf icon is a liver infection caused by the hepatitis B virus (HBV). A mother can transmit the infection to her baby during pregnancy. While the risk of an infected mother passing HBV to her baby varies, depending on when she becomes infected, the greatest risk happens when mothers become infected close to the time of delivery. 14 Infected newborns also have a high risk (up to 90%) of becoming chronic HBV carriers themselves. 15 Infants who have a lifelong infection with HBV are at an increased risk for developing chronic liver disease or liver cancer later in life. Approximately 25% of infants who develop chronic HBV infection will eventually die from chronic liver disease. 13 By screening your pregnant patients for the infection and providing treatment to at-risk infants shortly after birth, you can help prevent mother-to-child transmission of HBV. Information on mother-to-child transmission of HBV can be found at https://www.cdc.gov/hepatitis/HBV/PerinatalXmtn.htm.

Hepatitis C

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV), and can be passed from an infected mother to her child during pregnancy. In general, an infected mother will transmit the infection to her baby 10% of the time, but the chances are higher in certain subgroups, such as women who are also infected with HIV. 16 In some studies, infants born to HCV-infected women have been shown to have an increased risk for being small for gestational age, premature, and having a low birth weight. 15 Newborn infants with HCV infection usually do not have symptoms, and a majority will clear the infection without any medical help.

Herpes Simplex Virus

Herpes Simplex Virus (HSV) has two distinct virus types that can infect the human genital tract, HSV-1 and HSV-2. Infections of the newborn can be of either type, but most are caused by HSV-2. Generally, the symptoms of genital herpes are similar in pregnant and in nonpregnant women however, the major concern regarding HSV infection relates to complications linked to infection of the newborn. Although transmission may occur during pregnancy and after delivery, the risk of transmission to the neonate from an infected mother is high among women who acquire genital herpes near the time of delivery and low among women with recurrent herpes or who acquire the infection during the first half of pregnancy. 18 HSV infection can have very serious effects on newborns, especially if the mother&rsquos first outbreak occurred during the third trimester. Cesarean section is recommended for all women in labor with active genital herpes lesions or early symptoms, such as vulvar pain and itching. 19-20

Human Immunodeficiency Virus

Human immunodeficiency virus (HIV) is the virus that causes acquired immune deficiency syndrome, or AIDS. HIV destroys specific blood cells that are crucial to helping the body fight diseases. According to CDC&rsquos 2018 HIV surveillance data, women make up 24% of all adults and adolescents living with a diagnosed HIV infection in the United States and dependent areas. 2 The most common ways that HIV passes from mother to child are during pregnancy, labor, and delivery, or through breastfeeding. However, when HIV is diagnosed before or during pregnancy and appropriate steps are taken, the risk of mother-to-child transmission can be lowered to less than 2%. 3 A mother who knows early in her pregnancy that she is HIV-positive has more time to consult with you&mdashher healthcare provider&mdashand decide on effective ways to protect her health and that of her unborn baby.

Human Papillomavirus

Human papillomaviruses (HPV) are viruses that most commonly involve the lower genital tract, including the cervix, vagina, and external genitalia. Genital warts frequently increase in number and size during pregnancy. Genital warts often appear as small cauliflower-like clusters which may burn or itch. If a woman has genital warts during pregnancy, you may elect to delay treatment until after delivery. When large or spread out, genital warts can complicate a vaginal delivery. In cases where there are large genital warts that are blocking the birth canal, a cesarean section may be recommended. Infection of the mother may be linked to the development of laryngeal papillomatosis in the newborn&mdasha rare, noncancerous growth in the larynx . 17

Syphilis

Syphilis is primarily a sexually-transmitted disease, but it may be transmitted to a baby by an infected mother during pregnancy. Transmission of syphilis to a developing baby can lead to a serious multisystem infection, known as congenital syphilis. Recently, there has been a sharp increase in the number of congenital syphilis cases pdf icon in the United States. Syphilis has been linked to premature births, stillbirths, and, in some cases, death shortly after birth. 7 Untreated infants that survive tend to develop problems in multiple organs, including the brain, eyes, ears, heart, skin, teeth, and bones.

Trichomoniasis

Vaginal infection due to the sexually-transmitted parasite Trichomonas vaginalis is very common. Although most people report no symptoms, others complain of itching, irritation, unusual odor, discharge, and pain during urination or sex. If you have a pregnant patient with symptoms of trichomoniasis, she should be evaluated for Trichomonas vaginalis and treated appropriately. Infection in pregnancy has been linked to premature rupture of membranes, preterm birth, and low birth weight infants. 12 Rarely, the female newborn can acquire the infection when passing through the birth canal during delivery and have vaginal discharge after birth.

Screening and prompt treatment are recommended at least annually for all HIV-infected women, based on the high prevalence of T. vaginalis infection, the increased risk of pelvic inflammatory disease (PID) associated with this infection, and the ability of treatment to reduce genital tract viral load and vaginal HIV shedding. This includes HIV-infected women who are pregnant, as T. vaginalis infection is a risk factor for vertical transmission of HIV. For other pregnant women, screening may be considered at the discretion of the treating clinician, as the benefit of routine screening for pregnant women has not been established. 22 Screening might be considered for persons receiving care in high-prevalence settings (e.g., STD clinics or correctional facilities) and for asymptomatic persons at high risk for infection. Decisions about screening might be informed by local epidemiology of T. vaginalis infection. However, data are lacking on whether screening and treatment for asymptomatic trichomoniasis in high prevalence settings or persons at high risk can reduce any adverse health events and health disparities or reduce community burden of infection. 23

STD Treatment during Pregnancy

STDs, such as chlamydia, gonorrhea, syphilis, and trichomoniasis can all be treated and cured with antibiotics that are safe to take during pregnancy. Viral STDs, including genital herpes, hepatitis B, and HIV cannot be cured. However, in some cases these infections can be treated with antiviral medications or other preventive measures to reduce the risk of passing the infection to the baby. Detailed information on the management of specific STDs during pregnancy can be found in CDC&rsquos 2015 STD Treatment Guidelines.

STD Prevention during Pregnancy

After obtaining a sexual history from your patient, you should encourage risk reduction by providing prevention counseling. The most reliable way to avoid transmission of STDs is to abstain from oral, vaginal, and anal sex or to be in a long-term, mutually monogamous relationship with a partner known to be uninfected. For patients who are being treated for an STD other than HIV (or whose partners are undergoing treatment), counseling that encourages abstinence from sexual intercourse until completion of the entire course of medication is crucial. Latex male condoms, when used consistently and correctly, can reduce the risk of transmitting or acquiring STDs and HIV.

References

3. Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission. Recommendations for use of antiretroviral drugs in pregnant HIV-1-infected women for maternal health and interventions to reduce perinatal HIV transmission in the United States 2012 Jul 31:1&ndash235.

4. Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance, 2019. Atlanta, GA: Department of Health and Human Services April 2021.

5. Andrews WW, Goldenberg RL, Mercer B, Iams J, Meis P, Moawad A et al. The Preterm Prediction Study: association of second-trimester genitourinary Chlamydia infection with subsequent spontaneous preterm birth. Am J Obstet Gynecolo 2000183662&ndash8.

6. Alger LS, Lovchik JC, Heel JR, Blackmon LR, Crenshaw Mc. The association of Chlamydia trachomatis, Neisseira gonorrhoeae, and group B streptococci with preterm rupture of the membranes and pregnancy outcome. Am J Obstet Gynecol 1988159(2):397&ndash404.

7. Genc M, Ledger WJ. Syphilis in pregnancy external icon . Sex Transm Inf 200076:73.

8. Nelson DB, Macones G. Bacterial vaginosis in pregnancy: current findings and future directions. Epidemiolo Rev 200224(2):102&ndash8.

9. Hauth JC, Goldenberg RL, Andrews WW, Dubard MB, Copper RL. Reduced incidence of preterm delivery with metronidazole and erythromycin in women with bacterial vaginosis. N Engl J Med 1995333:1732&ndash6.

10. McDonald HM, O&rsquoLoughlin JA, Vigneswaran R, Jolley PT, Harvey JA. Impact of metronidazole therapy on preterm birth in women with bacterial vaginosis flora (Gardnerella vaginalis): a randomized, placebo controlled trial. Br J Obstet Gynecol 1997104:1391&ndash7.

11. Morales WJ, Schorr S, Albritton J. Effect of metronidazole in patients with preterm birth in preceding pregnancy and bacterial vaginosis: a placebo-controlled, double blind study. Am J Obstet Gynecol 1994171:345&ndash9.

12. Cotch MF, Pastorek JG II, Nugent RP, Hillier SL, Gibbs RS, Martin DH, et al: Trichomonas vaginalis associated with low birth weight and preterm delivery. Sex Transm Dis 199724(6):353&ndash60.

13. Hutto C, Arvin A, Jacobs R, Steele R, Stagno S, Lyrene R, et al. Intrauterine herpes simplex virus infections. J Pediatr 1987:110:97&ndash101.

14. Sookoian S. Liver disease during pregnancy: acute viral hepatitis. Ann Hepatol 2006 5:231.

15. Stevens CE, Toy PT, Tong MJ, et al. Perinatal hepatitis B virus transmission in the United States. Prevention by passive-active immunization. JAMA 1985 253:1740.

16. Yeung LT, King SM, Roberts EA. Mother-to-infant transmission of hepatitis C virus. Hepatology 2001 34:223.

17. Silverberg MJ, Thorsen P, Lindeberg H, Grant LA, Shah KV. Condyloma in pregnancy is strongly predictive of juvenile-onset recurrent respiratory papillomatosis. Obstet Gynecolo 2003101(4):645&ndash52.

18. Brown Z A, Wald A, Morrow R A, Selke S, Zeh J, Corey L. (2003) Effect of serologic status and cesarean delivery on transmission rates of herpes simplex virus from mother to infant. JAMA, 289(2), 203&ndash209.

19. American College of Obstetricians and Gynecologists (ACOG). ACOG Practice Bulletin. Clinical management guidelines for obstetrician-gynecologists. No. 82 June 2007. Management of herpes in pregnancy. Obstetrics and Gynecology, 2007. 109(6): 1489&ndash1498.

20. Workowski KA, Bolan GA, Centers for Disease Control and Prevention. Sexually Transmitted Diseases Treatment Guidelines, 2015 pdf icon . MMWR. 2015 64:1&ndash137.

21. US Preventive Services Task Force. Screening for bacterial vaginosis in pregnancy to prevent preterm delivery: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2008148:214&ndash9.

22. Meites E, Gaydos CA, Hobbs MM, Kissinger P, Nyirjesy P, Schwebke JR, et al. Review of Evidence-based Care of Symptomatic Trichomoniasis and Asymptomatic Trichomonas vaginalis Infections. Clinical Infectious Diseases. 2015 61:S837&ndash48.


SUMMARY

In some cases, pregnancy may have a profound effect upon the symptoms of autoimmune disease, such as in the case of RA and multiple sclerosis. The pregnancy-induced amelioration of select autoimmune diseases presents a unique opportunity to garner insight into both the maternal-fetal tolerance of pregnancy and pathogenic mechanisms in autoimmunity. We hypothesize that amelioration of RA results from changes in maternal peripheral tolerance, which occur by the simultaneous presentation of fetal and self (RA-associated) HLA peptides by tolerogenic dendritic cells. The mother’s immune system may temporarily alter its definition of “self” during pregnancy as tolerance develops to fetal HLA peptides with improvement of RA and some other autoimmune diseases as a secondary benefit. Alternatively, pregnancy may have no effect upon the mother’s symptoms, but instead target the developing fetus due to the placental transfer of maternal autoantibodies (e.g. Graves’ disease). The unique immunologic defects characteristic of each autoimmune disease are key to understanding the effect of pregnancy upon the mother’s disease course and her fetus.

Discovery of persistent fetal and maternal Mc decades after delivery has profound implications for autoimmunity, transplantation, and how we distinguish our own cells from �nger” signals (e.g. pathogens). The impact of Mc on the host is only beginning to be understood, but it is anticipated that effects of Mc are pleiotropic and range from adverse to neutral or even beneficial for the host, depending upon other factors with HLA genes and the HLA relationship among cells of key importance. Fetal Mc and HLA relationships between the fetal and mother’s cells have been studied in a number of autoimmune diseases with strongest evidence implicating fetal Mc in systemic sclerosis and autoimmune thyroiditis. Maternal Mc has also been associated with autoimmune diseases in the neonate and early childhood such as NLS and T1D. Elucidating mechanisms by which naturally acquired Mc is permitted without detriment to the host may lead to novel strategies with application to prevention and treatment of autoimmune diseases.


If I&rsquom depressed, will it affect my children?

Depression is treatable. But if it is not treated, it will affect your children.

Moms who are depressed may have trouble caring for their children. They may be loving one minute and withdrawn the next. They may respond to their child in a negative way or not respond at all. Your feelings and your behaviour will affect your ability to care for your children.

Depression can also affect attachment, which is important for your child&rsquos development. Attachment is a deep emotional bond that a baby forms with the person who provides most of his care. A &ldquosecure attachment&rdquo develops quite naturally. A mother responds to her crying infant, offering whatever she feels her baby needs&mdashfeeding, a diaper change, cuddling. Secure attachment helps protect against stress and is an important part of a baby&rsquos long-term emotional health. It makes a baby feel safe and secure, and helps him learn to trust others.

If you&rsquore depressed, you may have trouble being loving and caring with your baby all the time. This can lead to an &ldquoinsecure attachment,&rdquo which can cause problems later in childhood.

How a mother&rsquos depression affects her child depends on the child&rsquos age.

Babies who don&rsquot develop a secure attachment may:

  • have trouble interacting with their mother (they may not want to be with their mother, or may be upset when with them),
  • have problems sleeping,
  • may be delayed in their development,
  • have more colic,
  • be quiet or become passive, or
  • develop skills or reach developmental milestones later than other babies.

Toddlers and preschoolers whose mothers are depressed may:

  • be less independent,
  • be less likely to socialize with others,
  • have more trouble accepting discipline,
  • be more aggressive and destructive, or
  • not do as well in school.

School-aged children may:

  • have behaviour problems,
  • have trouble learning,
  • have a higher risk of attention deficit hyperactivity disorder (ADHD),
  • not do as well in school, or
  • have a higher risk of anxiety, depression and other mental health problems.

Teens whose mothers suffer from depression are at high risk for a number of problems such as major depression, anxiety disorder, conduct disorder, substance abuse, ADHD, and learning difficulties.


Existing Health Conditions

  • High blood pressure. Even though high blood pressure can be risky for the mother and fetus, most women with slightly high blood pressure and no other diseases have healthy pregnancies and healthy deliveries because they get their blood pressure under control before pregnancy. Uncontrolled high blood pressure, however, can damage the mother’s kidneys and increase the risk for low birth weight or preeclampsia. 1 It is very important for women to have their blood pressure checked at every prenatal visit so that healthcare providers can detect any changes and make decisions about treatment. Women with PCOS have higher rates of pregnancy loss before 20 weeks of pregnancy, diabetes during pregnancy (gestational diabetes), preeclampsia, and cesarean section. 2
  • Diabetes. It is important for women with diabetes to manage their blood sugar levels both before getting pregnant and throughout pregnancy. During the first few weeks of pregnancy, often before a woman even knows she is pregnant, high blood sugar levels can cause birth defects. Even women whose diabetes is well under control may have changes in their metabolism during pregnancy that require extra care or treatment to promote a healthy birth. 3 Babies of mothers with diabetes tend to be large and are likely to have low blood sugar soon after birth. That is another reason for women with diabetes to keep tight control of their blood sugar.
  • Kidney disease. Women with mild kidney disease often have healthy pregnancies. But kidney disease can cause difficulties getting and staying pregnant as well as problems during pregnancy, including preterm delivery, low birth weight, and preeclampsia. Nearly one-fifth of women who develop preeclampsia early in pregnancy are found to have undiagnosed kidney disease. 4 Pregnant women with kidney disease require additional treatments, changes in diet and medication, and frequent visits to their healthcare provider. 5,6
  • Autoimmune disease. Conditions such as lupus and multiple sclerosis can increase a women’s risk for problems during pregnancy and delivery. For example, women with lupus are at increased risk for preterm birth and stillbirth. Some women may find that their symptoms improve during pregnancy, while others have flare-ups and other challenges. Certain medicines to treat autoimmune diseases may be harmful to the fetus, meaning a woman with an autoimmune disease will need to work closely with a healthcare provider throughout pregnancy. 7
  • Thyroid disease. The thyroid is a small gland in the neck that makes hormones that help control heart rate and blood pressure. Uncontrolled thyroid disease, such as an overactive or underactive thyroid, can cause problems for the fetus, such as heart failure, poor weight gain, and brain development problems. Thyroid problems are usually treatable with medicine or surgery. 8 However, a recent NICHD-supported study found that treating mildly low thyroid function during pregnancy did not improve outcomes for mothers or their babies.
  • Obesity. Being obese before pregnancy is associated with a number of risks for poor pregnancy outcomes. For example, obesity increases a woman’s chance of developing diabetes during pregnancy, which can contribute to difficult births. 9Obesity can also cause a fetus to be larger than normal, making the birth process more difficult. NICHD research also found that obesity increases the risk for sleep apnea and disordered sleep breathing during pregnancy. Obesity before pregnancy is associated with an increased risk of structural problems with the baby’s heart.There can also be problems if overweight or obese women gain too much weight during pregnancy. NICHD research has shown that an integrated approach can help obese women to limit their weight gain during pregnancy, leading to better pregnancy outcomes. The Institute of Medicine recommends that overweight women gain no more than 15–25 pounds during pregnancy and that women with obesity gain no more than 11–20 pounds. 10 HIV can pass to a fetus during pregnancy, labor and delivery, and breastfeeding. Fortunately, there are effective treatments that can reduce and prevent the spread of HIV from mother to fetus or child. Medications for the mother and for the infant, as well as surgical delivery of the baby before the “water breaks” and feeding formula instead of breastfeeding, can prevent mother-to-child transmission and have led to a dramatic decrease in transmission—to less than 1% in the United States and other developed countries. 11 Although scientists and healthcare providers have known about Zika for decades, the link between Zika infection during pregnancy and pregnancy risks and birth defects has only recently come to light. NICHD-supported research has shown that infants born to mothers who were infected with Zika just before and during pregnancy were at higher risk for different problems with the brain and nervous system. The most noticeable is microcephaly, a condition in which the head is smaller than normal. Zika infection during pregnancy can also increase the woman’s risk for pregnancy loss and stillbirth. Researchers are still just learning the possible mechanisms of Zika’s effects on pregnancy.
  • Young age. Pregnant teens are more likely to develop pregnancy-related high blood pressure and anemia (lack of healthy red blood cells) and to go through preterm (early) labor and delivery than women who are older. Teens are also more likely to not know they have a sexually transmitted infection (STI). Some STIs can cause problems with the pregnancy or for the baby. 12 Teens may be less likely to get prenatal care or to keep prenatal appointments. Prenatal care is important because it allows a healthcare provider to evaluate, identify, and treat risks, such as counseling teens not to take certain medications during pregnancy, sometimes before these risks become problems. 13
  • First-time pregnancy after age 35. Most older first-time mothers have normal pregnancies, but research shows that older women are at higher risk for certain problems than younger women, 14 including:
    • Pregnancy-related high blood pressure (called gestational hypertension) and diabetes (called gestational diabetes) 15
    • Pregnancy loss 16
    • Ectopic pregnancy (when the embryo attaches itself outside the uterus), a condition that can be life-threatening 17
    • Cesarean (surgical) delivery
    • Delivery complications, such as excessive bleeding
    • Prolonged labor (lasting more than 20 hours)
    • Labor that does not advance
    • Genetic disorders, such as Down syndrome, in the baby 15

    Paternal addiction can have a large effect on children after birth. Parental smoking can increase the risk of childhood wheezing, bronchitis and asthma in children, although the connection between asthma was highest in children whose mothers smoked during pregnancy, according to an Austrian study analysis reported in the 2006 issue of "Tobacco Control." Sons of alcohol-addicted fathers have four times the risk of becoming alcoholics themselves, notes the National Association for Children of Alcoholics 4.

    The Effects of Crystal Meth During Pregnancy

    Animal studies have shown more effects from paternal addiction than human studies. It may be that more of a connection exists than has currently been uncovered. Up to 2011, studies have not proven that babies born to addicted fathers exhibit any particular symptoms in most cases unless their mother has the same addiction.


    Chlamydia complications

    If chlamydia isn't treated properly, it can cause serious complications. People who have chlamydia for long periods without treatment risk becoming infertile or developing arthritis.

    For women, chlamydia can spread into the uterus and fallopian tubes, causing pelvic inflammatory disease. Pelvic inflammatory disease can lead to ectopic pregnancies, chronic pelvic pain and infertility.

    In men, chlamydia can cause epididymitis (a painful infection near the testicle) or spread to the prostate gland, and the tubes that carry sperm, which may result in chronic pain and/or fertility problems.

    Both men and women can develop arthritis, eye inflammation and inflammation of the rectum.


    Change in Mother’s Mental State Can Influence Her Baby’s Development Before and After Birth

    As a fetus grows, it’s constantly getting messages from its mother. It’s not just hearing her heartbeat and whatever music she might play to her belly it also gets chemical signals through the placenta. A new study, which will be published in Psychological Science, a journal of the Association for Psychological Science, finds that this includes signals about the mother’s mental state. If the mother is depressed, that affects how the baby develops after it’s born.

    In recent decades, researchers have found that the environment a fetus is growing up in—the mother’s womb—is very important. Some effects are obvious. Smoking and drinking, for example, can be devastating. But others are subtler studies have found that people who were born during the Dutch famine of 1944, most of whom had starving mothers, were likely to have health problems like obesity and diabetes later.

    Curt A. Sandman, Elysia P. Davis, and Laura M. Glynn of the University of California-Irvine study how the mother’s psychological state affects a developing fetus. For this study, they recruited pregnant women and checked them for depression before and after they gave birth. They also gave their babies tests after they were born to see how well they were developing.

    They found something interesting: what mattered to the babies was if the environment was consistent before and after birth. That is, the babies who did best were those who either had mothers who were healthy both before and after birth, and those whose mothers were depressed before birth and stayed depressed afterward. What slowed the babies’ development was changing conditions—a mother who went from depressed before birth to healthy after or healthy before birth to depressed after. “We must admit, the strength of this finding surprised us,” Sandman says.

    Now, the cynical interpretation of our results would be that if a mother is depressed before birth, you should leave her that way for the well-being of the infant. “A more reasonable approach would be, to treat women who present with prenatal depression. Sandman says. “We know how to deal with depression.” The problem is, women are rarely screened for depression before birth.

    In the long term, having a depressed mother could lead to neurological problems and psychiatric disorders, Sandman says. In another study, his team found that older children whose mothers were anxious during pregnancy, which often is co morbid with depression, have differences in certain brain structures. It will take studies lasting decades to figure out exactly what having a depressed mother means to a child’s long-term health.

    “We believe that the human fetus is an active participant in its own development and is collecting information for life after birth,” Sandman says. “It’s preparing for life based on messages the mom is providing.”