Pregnancy Can Be Anxious Time for Women With Epilepsy

"The good news is we did not find that pregnant women with epilepsy were any more likely to have episodes of major depression than the other two groups," said study author Dr. Kimford Meador, a professor of neurology at Stanford University School of Medicine, and a fellow of the American Academy of Neurology. "However, these results underscore the importance of regularly screening pregnant women with epilepsy for any signs of depression or anxiety and providing effective treatment," he said. The new study included 331 women who were pregnant and had epilepsy, 102 pregnant women without epilepsy, and 102 women who had epilepsy but were not pregnant. Researchers met with the pregnant women during each trimester, near their delivery and every three months until nine months afterward, screening them for depression, anxiety and other psychiatric disorders. The researchers met with the women who were not pregnant at comparable time points. They found that pregnant women with epilepsy were more likely to have symptoms of depression during pregnancy than the women with epilepsy who were not pregnant. After giving birth, they were more likely to have depression symptoms than both other groups. During pregnancy, the women with epilepsy had an average score of 7 on a test of depression symptoms, compared to an average score of 6 for pregnant women without epilepsy. Women who were not pregnant but had epilepsy had an average score of 5. A score of 10 or higher shows mild mood disturbance. Compared to both other groups, pregnant women with epilepsy also had more symptoms of anxiety. On a test of anxiety symptoms, they scored a 6, while the other groups scored a 5. A score of 8 or more indicates mild anxiety. The investigators found no evidence of major depression, but they did identify risk factors. They included more than one seizure in the past three months; taking more than one epilepsy drug; having an unplanned pregnancy, and a history of mood disorders. The findings were published Aug. 17 in Neurology. "Depression is often under-recognized in people with epilepsy, yet we know that effective management of depression can improve people’s quality of life and their overall outcomes for epilepsy treatment, so women with epilepsy should be monitored closely during pregnancy and evaluated when they are thinking about planning a pregnancy," Meador said in a journal news release. The researchers noted that the study had several limitations. It did not include enough women to fully evaluate the impact of individual epilepsy medications on symptoms of depression and anxiety. In addition, they said participants may not have recalled symptoms that occurred between study visits.

Pregnancy and Body Image in a Post-Roe World

My friend Heather was recently describing her experiences after the birth of her first child: “Every day was overwhelming. It was like taking a test I hadn’t studied for over and over again. Meanwhile, everyone seemed to think my life should go back to ‘normal’ immediately. I should go back to work, sleep through the night, and my body should return to its pre-baby form. None of that was happening for me, and it was depressing.” Portrait of young pregnant woman standing by the window (GETTY IMAGES) There are times during women’s lives that involve dramatic physical changes, including puberty, pregnancy and menopause. Hormonal changes are implicated in all of these physical transformations, but the experiences of growing a fetus during pregnancy, delivering a baby and nursing a child can take an especially far-reaching toll – emotionally and physically. Body Dissatisfaction After Pregnancy Research suggests that body dissatisfaction often dominates the postpartum experience. On the one hand, this probably seems completely commonsensical, while on the other, our cultural dialogue about “getting your pre-baby body back” seems to dominate discussions of pregnancy and women’s bodies suggesting that postpartum body dissatisfaction is a simple problem to solve. Women report a great deal of concern about stretch marks, changes to their breasts and overall weight gain associated with pregnancy. These concerns are not merely superficial. One recent study even suggests that poor body image is often associated with depression postpartum. My friend may have felt like she was the only one not living up to social expectations postpartum, but the research suggests otherwise. [ READ: What Is an Ectopic Pregnancy? ] Breastfeeding and Disordered Eating Further, women who are dissatisfied with their bodies are more likely to stop breastfeeding before six months and report more embarrassment about breastfeeding. In some of my own research, my colleagues and I found that women with more body image concerns were not only likely to stop breastfeeding but also engage in disordered eating. All of this research suggests that the consequences of women’s body dissatisfaction postpartum may affect not just women but also their children. I’ve been thinking about all of this a lot in the last few weeks as the realities of a post-Roe world settle in. There are many physical and mental health challenges and complications associated with pregnancy. Although past research examining links between body image and pregnancy do not tend to ask women if they desired their pregnancies, it's likely that women who agree to participate in such research were glad to be pregnant and have a child. And yet, many of these women struggled with their body image and this had real consequences for their mental and behavioral health. [ READ: Natural Birth Control Methods: Do They Work? ] The Physical Changes of Pregnancy One of my former students, Lily, shared that she was surprised that books about motherhood gloss over all the physical changes associated with pregnancy. She joked that being told to view stretch marks as a badge of honor is not especially helpful. Lily told me that the messaging about, “getting your pre-baby body back” felt so toxic to her that it really contributed to her dislike of being pregnant and her postpartum body dissatisfaction. Of course, the experience of pregnancy doesn’t always leave women dissatisfied with their bodies. I know more than one woman who felt empowered by her pregnancy and valued her body less for what it looked like and more for what it was capable of postpartum – even while in the throes of sleep-deprivation. My friend Katie was trying to get pregnant with her second child when she learned that she had breast cancer. What followed was (successful!) cancer treatment, IVF and eventually a second son. Those years were scary, but the desire to be around to parent her son and have another child were ever-present. Today, she is so grateful for all that her body has been able to withstand and the two boys that she adores. But even she will admit that it’s hard not to wish for her pre-baby body. [ READ: How to Find a Good Fertility Clinic. ] The Consequences of Unintended Pregnancies It’s difficult to imagine how unintended pregnancies – in some cases, the result of incest or rape – that women are forced to carry, will not have devastating consequences for women’s body image and their mental health in general. There’s a lot women can’t control when it comes to their ability to get pregnant, to carry a pregnancy to term, to deliver a healthy child and to physically and psychologically recover from these experiences. Women deserve body autonomy when it comes to deciding to embark on this journey.

Family History of Mental Illness Ups Odds for Postpartum Depression

By Amy Norton HealthDay Reporter (HEALTHDAY) MONDAY, Aug. 22, 2022 (HealthDay News) -- Pregnant women with a family history of any mental health condition may be at increased risk of depression after giving birth, a new research review finds. Recommended Videos Powered by AnyClip Queen's family rush to side of ailing monarch 45 Play Video Queen's family rush to side of ailing monarchNOW PLAYING Queen's family rush to side of ailing monarch Lack of youth sports leaving kids depressed COVID-19 becomes the second-worst pandemic in U.S. history Psychologist offers mental advice for dealing with coronavirus In an analysis of 26 studies, researchers found that women with a family history of psychiatric diagnoses were at heightened risk of postpartum depression. On average, they were twice as likely to be diagnosed with the condition as women with no such family history. The findings — published online Aug. 17 in JAMA Psychiatry — don't mean that family history dooms some women to developing depression after giving birth. Simply having a risk factor "does not automatically result in postpartum depression," said lead researcher Mette-Marie Zacher Kjeldsen of Aarhus University in Denmark. But, she said, it's important to know what factors make some women more vulnerable to the condition and the extent of the added risk. Postpartum depression is common. In the United States alone, roughly one in eight women report depression symptoms soon after giving birth, according to the U.S. Centers for Disease Control and Prevention. Guidelines say that all new mothers should be screened for postpartum depression, by both their obstetrician and their baby's pediatrician, the doctor who may see them most often. The American Academy of Pediatrics recommends screening moms during babies' routine check-ups over the first six months of life. But while any new mother can develop depression, there are some factors that raise the risk. Those include a history of depression before pregnancy, or having little support from family and friends. When it comes to mental health in general, Kjeldsen said, it's well known that family history matters: Studies looking at various psychiatric conditions have consistently found it to be a risk factor. But the new findings help "quantify" the impact of family history on the risk of postpartum depression, said Anna Bauer, an assistant professor of psychiatry at the University of North Carolina at Chapel Hill School of Medicine. Beyond that, Bauer said, it appears to be family history of any psychiatric condition — not only depression — that matters. Bauer, who was not involved in the study, said that while no one can change their family history, it's important to understand its role as a risk factor for postpartum depression. Doctors may, for instance, want to screen those new mothers for depression more often. As for why family members' mental health matters, Kjeldsen said past research suggests it's a combination of genes and environment. Family members may share some genes that make them more vulnerable to psychiatric conditions — and they may also share life experiences and exposures that do the same. Plus, Kjeldsen pointed out, there's the role of family support. If a woman's family members are struggling with their own mental health issues, she might not get the support she needs after giving birth. The findings are based on more than 100,000 women who participated in 26 studies across the globe. They were considered to have a family history if a "close or extended family member" had ever suffered from a psychiatric disorder (usually based on the women's own reports, collected before any diagnosis of postpartum depression). Overall, the study found, those women had twice the risk of being diagnosed with postpartum depression compared to new mothers with no family history of mental health disorders. According to Bauer, it's important for new mothers and their families to be aware that postpartum depression is a common psychiatric condition and not a personal failing. Some women, she noted, can feel guilty about being depressed at a time when they think they're "supposed to" be happy. "A new mother should not feel shame about this," Bauer said. She also stressed that there are effective treatments for depression, both medication and counseling. It is normal to be tired or have mood swings after giving birth, Bauer said: A new mother is caring for a newborn, short on sleep, going through body changes and dealing with a major life adjustment. But some mood and behavior changes, Bauer said, can be red flags, such as feeling too run down to get out of bed, or being unable to sleep; strong feelings of sadness or anxiety; appetite loss; and disinterest in activities you once enjoyed. More information The March of Dimes has more on postpartum depression. SOURCES: Mette-Marie Zacher Kjeldsen, MSc, doctoral student, National Center for Register-based Research, Aarhus University, Aarhus, Denmark; Anna Bauer, MPH, PhD, assistant professor, psychiatry, University of North Carolina at Chapel Hill School of Medicine; JAMA Psychiatry, Aug. 17, 2022, online Copyright © 2022 HealthDay. All rights reserved.

Hypertension in Pregnancy Is Getting More Common for Gen Z Women

By By Steven Reinberg HealthDay Reporter, HealthDay Reporter (HEALTHDAY) MONDAY, Aug. 29, 2022 (HealthDay News) -- Gen Zers and millennials are about twice as likely to develop high blood pressure during pregnancy than women from the baby boom generation were, a new study finds. This includes conditions such as preeclampsia and gestational hypertension. Recommended Videos Powered by AnyClip Apple product announcement 'more of the same' -CIO 18.1K Play Video Ad: (10) Apple product announcement 'more of the same' -CIONOW PLAYING Two women drive the metro for the first time in Egypt 'The grass is gone': Texas drought means more cattle facing slaughter 12 more die in floods near Pakistan's Manchar lake Pakistan's homeless flood victitms ask for more aid It's usually believed that the odds of developing high blood pressure during pregnancy rise with the age of the mother, but after taking age into account, researchers discovered that women born in and after 1981 were still at greater risk. "While there are many reasons for the generational changes observed, we hypothesize that this is, in large part, due to the observed generational decline in heart health," said study co-author Dr. Sadiya Khan, an assistant professor at Northwestern University Feinberg School of Medicine in Chicago. "We are seeing more people in more recent generations entering pregnancy with risk factors such as obesity." She emphasized that the stakes are high. "High blood pressure during pregnancy is a leading cause of death for both mom and baby," Khan said in a school news release. "High blood pressure during pregnancy is associated with increased risk of heart failure and stroke in the mother and increased risk of the baby being born prematurely, being growth restricted or dying." The researchers drew numbers from the National Vital Statistics System Natality Database. The study, which included data from more than 38 million women, focused on first pregnancies that occurred between 1995 and 2019. These numbers allowed them to match high blood pressure-related disorders during pregnancy with mothers' birth year and race or ethnicity. They found that the highest rates were among American Indian, Alaskan Native and Black women. "This is the first multi-generational study that moves beyond the age of the mom or the calendar year of the delivery to understand patterns of hypertension in pregnancy," Khan said. "This is especially important when we look at the legacy of substantial racial and ethnic disparities in this high-risk condition that affects not only the mom but also the baby," she said. "This sets up a vicious cycle of generational health decline by starting life with poorer heart health." Co-author Dr. Natalie Cameron, an instructor of medicine at Northwestern, said the findings call for a new approach to screening. "The public health and clinical message from this work is the need to broaden our perspective on screening and expand our focus on prevention in all age groups before and during pregnancy, particularly among younger people who have traditionally not been considered at high risk," Cameron said in the release. Khan agreed. "Prevention and earlier identification can be lifesaving and improve the health of future generations beginning at birth," she said. The study was published online Aug. 24 in JAMA Open Network. More information The U.S. Centers for Disease Control and Prevention has more about high blood pressure during pregnancy. SOURCE: Northwestern Medicine, news release, Aug. 24, 2022 Copyright © 2022 HealthDay. All rights reserved. Tags: pregnancy, high blood pressure, race

Pregnant Women Face Exposures to Dangerous Chemicals Daily

By By Steven Reinberg HealthDay Reporter, HealthDay Reporter (HEALTHDAY) TUESDAY, Aug. 30, 2022 (HealthDay News) -- Pregnant women are exposed to toxic chemicals in dishware, hair coloring, plastics and pesticides that can heighten their risk of cancer and harm child development, a new study warns. Recommended Videos Powered by AnyClip Pregnant Pakistanis face risky journey to give birth 722 Play Video Pregnant Pakistanis face risky journey to give birthNOW PLAYING Sri Lanka readies for oil spill from cargo ship Cher says Kaavan will no longer be a prisoner The tiny Alaskan island fighting for its future Sea of litter and tents left behind after Reading festival Melamine and its major byproduct, cyanuric acid, were found in nearly all the 171 women in the study and levels were highest among women of color and those exposed to tobacco. In addition, four aromatic amines that are used in dyes and pigments were also found in nearly all pregnant participants. "These chemicals are of serious concern due to their links to cancer and developmental toxicity, yet they are not routinely monitored in the United States," researcher Tracey Woodruff said in a news release from the University of California, San Francisco. She directs the university's Program on Reproductive Health and the Environment. Melamine is found in dishware, plastics, flooring, kitchen counters and pesticides. Cyanuric acid is used as a disinfectant, plastic stabilizer and cleaning solvent in swimming pools. Aromatic amines are found in hair dye, mascara, tattoo ink, paint, tobacco smoke and diesel exhaust, the researchers said. People can be exposed to the chemicals through the air they breathe, through ingestion or using products that contain plastic, dyes and pigments. When exposure to melamine and cyanuric acid happens together, they can be more toxic than either one alone, researchers said in background notes. For the study, the investigators measured 45 chemicals linked with cancer and other risks in urine samples from a diverse group of 171 women who were part of the U.S. National Institutes of Health's Environmental influences on Child Health Outcomes Program. "It's disconcerting that we continue to find higher levels of many of these harmful chemicals in people of color," said study co-author Jessie Buckley, an associate professor at Johns Hopkins Bloomberg School of Public Health in Baltimore. For example, levels of 3,4-dichloroaniline (a chemical used in the production of dyes and pesticides) were more than 100% higher among Black and Hispanic women compared with white women. "Our findings raise concerns for the health of pregnant women and fetuses since some of these chemicals are known carcinogens and potential developmental toxicants," said co-author Giehae Choi, a postdoctoral fellow at the Bloomberg School of Public Health. "Regulatory action is clearly needed to limit exposure."

What happens at each stage of breast cancer?

Breast cancer stages aim to describe how far cancer has progressed. The stage will affect the different symptoms and treatment options. Doctors use various ways to stage breast cancer. Four broad stages define where the cancer is, whether it is still in its original location or if it has spread to other parts of the body. However, a doctor will also use other systems and information to identify the stage and decide which treatment is most suitable and what the outlook is likely to be. It is worth noting that the stage is not the only factor that affects treatment and other decisions. Other considerations include markers such as hormone receptivity, the cancer grade, the type, the person’s overall health, and so on. Each case will be different. However, a doctor can help the individual understand how cancer will affect them and what to expect. The American Joint Committee on Cancer (AJCC) oversees the staging of breast cancer. As a result, all cancer doctors describe and classify the stages of cancer in the same way. AJCC’s staging is the most commonly used method for breast cancer and allows all doctors to describe, classify, and stage cancer in the same way. It involves two systems: pathological staging and clinical staging. BEZZY COMMUNITY Shared Breast Cancer Stories and More Tap into community conversations discussing breast cancer diagnoses, backed by our powerful BC community. Bezzy BC: empowered by each other. Identifying the stage Iru Meladze/EyeEm/Getty Images One way to identify the stage is to look at body tissue and see how far cancer cells have spread. This gives the following broad stages: In situ: There is a change in cells that could become cancerous and invade other tissue over time. Localized: A tumor is present but has not spread. Regional: Cancer has spread beyond the original location to nearby lymph nodes. Distant or metastatic: Cancer has spread to other parts of the body and other organs beyond the original location. However, this description alone does not reflect the complexities of breast cancer. For this reason, doctors also use other methods and other informationTrusted Source. TNM staging Crucial to breast cancer staging is the TNM system. The letters TNM mean the following: T = tumor: This indicates the extent or size of the tumor and how much breast tissue it involves. N = nodes: This shows whether cancer has spread to the lymph nodes and how many it has affected. M = metastasis: This is when cancer has spread to other parts of the body, such as distant organs, tissues, and the bones. The TNM staging system also uses numbersTrusted Source. The numbers, from 0 to 4, describe the stage, and information from the TNM staging helps determine the number. Other factors affecting treatment options and outlook are the status and grade. Tumor status A doctor will use test results showing the presence and absence of specific biomarkers to assess the tumor status. They will ask one or more of the following questions while reviewing the results: Are there estrogen-receptor proteins (Is is ER+ or ER-)? Are there progesterone receptor proteins (Is it PR+ or PR-)? Does it produce high levels of a protein HER2 (Is it HER2+ or HER2-)? Is it triple negative, in other words, EE-, PR- and HER2-? What genetic patternsTrusted Source show up if genetic testing is done? Cancer grading The grade indicates how fast cancer is likely to grow and to what extent they look like normal cells. It can be: Grade 1 or low grade: The cells look similar to healthy tissue and will likely grow slowly. Grade 2 or intermediate grade: The cells looks somewhat different and will likely grow at a moderate rate. Grade 3 or high grade: The cells look very different and may be fast growing. Diagnostic tests To determine the stage, a doctor may perform tests, including: a physical examination blood tests biopsies CT and PET scans MRI X-rays, including a mammogram ultrasounds It is also worth noting that, while initial tests can help stage and grade cancer, the doctor may need to revise their decision as more information becomes available. Lab tests on a tumor after surgery, for example, may provide information that is different from the results of a biopsy because there is more tissue to analyze.

Invasive lobular breast cancer: Prognosis and statistics

Invasive lobular carcinoma is the second most common type of breast cancer. It affects the lobules of the breast, which are the structures that contain the glands that produce breast milk. According to the American Cancer SocietyTrusted Source, about 10 percent of people who get invasive breast cancer have invasive lobular carcinoma (ILC). Approximately 80 percentTrusted Source of people with invasive breast cancer have invasive ductal carcinoma (IDC). It is the most common type of breast cancer, and it affects the ducts that carry milk through the breast. If a lobular breast cancer is invasive, this means that it has spread beyond the lobule to other parts of the breast. In some people, it spreads beyond the breast tissue into other parts of the body. ILC can develop at any age, but it tends to be more common in older people. Some evidence suggests that using hormonal replacement therapy after menopause may increase the riskTrusted Source. In this article, learn more about the prognosis and survival rates for ILC, as well as how doctors treat the disease. BEZZY COMMUNITY Shared Breast Cancer Stories and More Tap into community conversations discussing breast cancer diagnoses, backed by our powerful BC community. Bezzy BC: empowered by each other. Prognosis Laurent Hamels/Getty Images The prognosis (future outlook) after a cancer diagnosis depends on several factors, including: the size of the cancer whether the cancer has spread and where it has spread to a person’s age a person’s general state of health the effectiveness of the treatment the cancer grade, which measures how abnormal the cells appear at a microscopic level the results of certain markers, including estrogen receptor, progesterone receptor, and HER2/neu The prognosis also varies depending on the stage of the cancer. A lower number means that the cancer is in an earlier stage, while a higher number means that the cancer has advanced. Survival rate A survival rate can show how many people with the same type and stage of cancer are still living 5 or more years after receiving the diagnosis. These statistics do not take age or overall health into consideration. In general, if doctors diagnose and treat cancer in the early stages, survival rates tend to be higher. If cancer has advanced, for example by spreading beyond the breast tissue, survival rates are likely to be lower. Depending on the stage of breast cancer, the general 5-year survival rates for women are: Stage 0 or 1: nearly 100 percent Stage 2: about 93 percent Stage 3: around 72 percent Stage 4: approximately 22 percent Treatment Doctors can treat ILC in two ways: locally and systemically. Local treatments for ILC target the tumor and the area that immediately surrounds it. These treatments can include surgery, such as a lumpectomy or mastectomy, or radiation therapy that directly attacks the cancer. Systemic treatments for ILC attack cancer cells that have spread beyond the breast tissue. Chemotherapy and hormonal therapy are the two main systemic treatments for ILC. Targeted therapies such as palbociclib or verzenio are often used for advanced stages, particularly stage 4 breast cancer. Depending on how advanced the cancer is, a doctor may recommend a combination of local and systemic treatments. Most invasive breast cancers (even stage 1) can be treated with a combination therapies such as surgery and hormonal therapy or surgery and radiation. An oncologist, or cancer specialist, will help determine the best treatment plan for each person. They will take several factors into account, including the person’s general health and the grade and stage of the cancer. BEZZY COMMUNITY Shared Breast Cancer Stories and More Tap into community conversations discussing breast cancer diagnoses, backed by our powerful BC community. Bezzy BC: empowered by each other. Remission If treatment cures cancer, this means that it destroys all of the cancer cells, and they do not return. Although this is the goal of treatment, it is not always possible. Often, cancer goes into remission, meaning the patient has no evidence of cancer. A person may have few or no clinical symptoms, but cancer cells still exist in the body. Some doctors consider someone whose cancer has been in remission for 5 years or more. Cancer cells can survive in the body for many years. If a cancer recurs after the initial treatment, most tend to do so within the first 5 years of diagnosis. During remission, a doctor carefully checks for any indications of the cancer’s return, as well as for any late side effects of treatment. Summary Receiving a cancer diagnosis can be stressful, and many people worry about the outcome. When doctors diagnose ILC in early stages, survival rates are higher. There are several treatment options for ILC, depending on the stage and nature of the cancer. Joining a support group and talking to loved ones can help a person cope with the challenges of a cancer diagnosis. Article resources Breast cancer stages. (2022). https://www.breastcancer.org/pathology-report/breast-cancer-stages Invasive breast cancer (IDC/ILC). (2021). https://www.cancer.org/cancer/breast-cancer/about/types-of-breast-cancer/invasive-breast-cancer.htmlTrusted Source Invasive lobular carcinoma (ILC). (2022). https://www.breastcancer.org/types/invasive-lobular-carcinoma Li, C. I.,et al. (2015). Use of menopausal hormone therapy and risk of ductal and lobular breast cancer among women 55–74 years of age. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4075765/Trusted Source Survival rates for breast cancer. (2021). https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.htmlTrusted Source Understanding cancer prognosis. (2019). https://www.cancer.gov/about-cancer/diagnosis-staging/prognosis