Frozen embryo transfers linked with high blood pressure risks in pregnancy; What is sibling comparison?

Posted on September 26, 2022 by Naresh Kumar

In vitro fertilization (IVF) using frozen embryos may be associated with a 74% higher risk of hypertensive disorders in pregnancy, according to new research published today in Hypertension, an American Heart Association journal.

In comparison, the study found that pregnancies from fresh embryo transfers – transferring the fertilized egg immediately after in vitro fertilization (IVF) instead of a frozen, fertilized egg – and pregnancy from natural conception shared a similar risk of developing a hypertensive disorder.

High blood pressure during pregnancy often signals preeclampsia, a pregnancy complication including persistent high blood pressure that can endanger the health and life of the mother and fetus. Approximately 1 out of every 25 pregnancies in the United States results in preeclampsia, according to the American Heart Association.

One IVF treatment process available utilizes frozen embryos: after an egg is fertilized by sperm in the lab, it is frozen using a cryopreservation process before being thawed and transferred to the uterus at a later date. The procedure is becoming more common because of the significantly improved freezing technology or cryopreservation methods that started in the late 2000s and because more patients are choosing to freeze embryos, according to the study authors. Yet, frozen embryo transfer is known to be associated with a higher risk of hypertensive disorders in pregnancy than both natural conception and fresh embryo transfer. However, prior to this study, it was unknown whether this was due to the freezing process or a risk factor from the parents.

“Frozen embryo transfers are now increasingly common all over the world, and in the last few years, some doctors have begun skipping fresh embryo transfer to routinely freeze all embryos in their clinical practice, the so-called ‘freeze-all’ approach,” said Sindre H. Petersen, M.D., the study’s lead author and a Ph.D. fellow at the Norwegian University of Science and Technology in Trondheim, Norway.

Researchers examined national data from medical birth registries from Denmark, Norway and Sweden of nearly 2.4 million women who were ages 20 to 44 years old who had single deliveries and gave birth during the study period – from 1988 through 2015. These data were the basis of a population-based study that also included a comparison of women who had both an IVF pregnancy and a naturally conceived pregnancy, called sibling comparison. This approach was used to isolate if the potential reason for the hypertensive disorders was attributable to parental factors or to the IVF treatment.

pregnant lady/Commons.wikimedia.org

The study included more than 4.5 million pregnancies, of which 4.4 million were naturally conceived; more than 78,000 pregnancies were fresh embryo transfers; and more than 18,000 pregnancies were frozen embryo transfers. Among all of the pregnancies, more than 33,000 were grouped for sibling comparison – mothers who conceived via more than one of these methods. The study is the largest to-date using sibling comparison. The odds of developing hypertensive disorders in pregnancy after fresh vs. frozen embryo transfers compared to natural conception were adjusted for variables such as birth year and the mother’s age.

“In summary, although most IVF pregnancies are healthy and uncomplicated,” Petersen said. “This analysis found that the risk of high blood pressure in pregnancy was substantially higher after frozen embryo transfer compared to pregnancies from fresh embryo transfer or natural conception.”

Specifically, the study found:

In the population analysis, women whose pregnancy was the result of a frozen embryo transfer were 74% more likely to develop hypertensive disorders in pregnancy compared to those who conceived naturally.
Among women who had both a natural conception and an frozen embryo transfer IVF conception (the sibling comparison), the risk of hypertensive disorders in pregnancy after frozen embryo transfer was twice as high compared to pregnancies from natural conception.
Pregnancies from fresh embryo transfer did not have a higher risk of developing hypertensive disorders compared to natural conception, neither in population level analysis nor in sibling comparisons.

“Our sibling comparisons indicate that the higher risk is not caused by factors related to the parents, rather, however, that some IVF treatment factors may be involved,” Petersen said. “Future research should investigate which parts of the frozen embryo transfer process may impact risk of hypertension during pregnancy.”

Among other findings, women in the study who gave birth after IVF pregnancies were average age 34 years for frozen embryo transfer, 33 years for fresh embryo transfer and 29 years for those who conceived naturally. About 7% of babies conceived from frozen embryo transfer were born preterm (before 40 weeks gestation) and 8% of babies after fresh embryo transfer were born preterm, compared to 5% of babies after natural conception.

In addition to preeclampsia, the researchers defined hypertensive disorders in pregnancy as a combined outcome, including gestational hypertension, eclampsia (the onset of seizures in those with preeclampsia) and chronic hypertension with superimposed preeclampsia.

One limitation of the study was the lack of data on the kind of frozen embryo cycle, so they were not able to pinpoint what part of the frozen cycle or frozen transfer may contribute to the higher risk of hypertensive disorders. Another limitation is that data from Scandinavian countries may limit generalizing the findings to people in other countries.

“Our results highlight that careful consideration of all benefits and potential risks is needed before freezing all embryos as a routine in clinical practice. A comprehensive, individualized conversation between physicians and patients about the benefits and risks of a fresh vs. frozen embryo transfer is key,” said Petersen.

Eating behavior of parents plays key role in child’s emotional eating

Posted on September 7, 2022 by Srinivas Chakravarty

Emotional eating, or eating as a coping mechanism for negative, positive, or stress-driven emotions, is associated with unhealthy dietary patterns and weight gain. A research article featured in the Journal of Nutrition Education and Behavior, published by Elsevier, discusses adolescent vulnerability to emotional eating and how various feeding practices used by parents, such as restriction, food as reward, and child involvement, influence eating behavior.

“Emotional eating was previously found to be more learned than inherited. This study examined not only the interaction between parents when feeding their children, but also what children learned from watching their parents eat,” said lead author Joanna Klosowska, MSc, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.

Eating/Photo:en.wikipedia.org

Over the four years between 2013 −2017, covering the time from late childhood to middle adolescence, changes occurred in some parental practices. Parents reported higher monitoring and healthy modeling feeding practices, while the reported levels of food restriction and the healthy environment remained unchanged. During the same time period, adolescents reported a considerable increase in emotional eating from below the average in 2013 to above the average in 2017, according to the norms for the Dutch population. Additionally, the maladaptive way in which they regulated their emotions was also associated with emotional eating.

Dining/Photo:en.wikipedia.org

Food as a reward and monitoring food increased emotional eating especially in instances where the adolescent employed maladaptive strategies in regulating their emotions. Child involvement in meals had an opposite effect since it was associated with higher levels of emotion regulation and lower levels of emotional eating. Interestingly, a parent’s restrained eating behavior was linked to less emotional eating in adolescents.

“This study suggests that parents continue to play an important role in their child’s eating behavior into their teen years,” said Klosowska. “Additional research is needed to understand the impact restrained eating demonstrated by a parent impacts the emotional eating of a child.”

Insufficient sleep in teenagers leads to obesity: Study

Posted on August 24, 2022 by Arun Kumar

Adolescents who sleep less than eight hours a night are more likely to be overweight or obese compared to their peers with sufficient sleep, said a new study presented at ESC Congress 2022.

Shorter sleepers were also more likely to have a combination of other unhealthy characteristics including excess fat around the middle, elevated blood pressure, and abnormal blood lipid and glucose levels, said the study by Jesús Martínez Gómez, a researcher at the Cardiovascular Health and Imaging Laboratory, Spanish National Centre for Cardiovascular Research (CNIC), Madrid, Spain.

“Our study shows that most teenagers do not get enough sleep and this is connected with excess weight and characteristics that promote weight gain, potentially setting them up for future problems,” said study author Gómez. “We are currently investigating whether poor sleep habits are related to excessive screen time, which could explain why older adolescents get even less sleep than younger ones.”

Sleep/en.wikipedia.org

This study examined the association between sleep duration and health in 1,229 adolescents in the SI! Program for Secondary Schools trial in Spain. Participants had an average age of 12 years at baseline with equal numbers of boys and girls.

Sleep was measured for seven days with a wearable activity tracker three times in each participant at ages 12, 14 and 16 years. For optimal health, the American Academy of Sleep Medicine advises sleeping 9 to 12 hours a night for 6 to 12 year-olds and 8 to 10 hours for 13 to 18 year-olds.³To simplify the analysis, the study used 8 hours or more as optimal. Participants were categorized as very short sleepers (less than 7 hours), short sleepers (7 to 8 hours), and optimal (8 hours or more).

Overweight and obesity were determined according to body mass index. The researchers calculated a continuous metabolic syndrome score ranging from negative (healthier) to positive (unhealthier) values that included waist circumference, blood pressure, and blood glucose and lipid levels.

At 12 years of age, only 34% of participants slept at least 8 hours a night, and this dropped to 23% and 19% at 14 and 16 years of age, respectively. Boys tended to get less sleep. Teenagers who got the most sleep also had better quality sleep, meaning they woke up less during the night and spent a higher proportion of the time in bed sleeping compared to those with shorter sleep. The prevalence of overweight/obesity was 27%, 24% and 21% at 12, 14 and 16 years of age, respectively.

Compared with optimal sleepers, overweight/obesity was 21% and 72% more likely in very short sleepers at 12 and 14 years, respectively. Short sleepers were 19% and 29% more likely to be overweight/obese compared with optimal sleepers at 12 and 14 years, respectively. Similarly, both very short and short sleepers had higher average metabolic syndrome scores at 12 and 14 years compared with optimal sleepers.

Mr. Martínez Gómez said: “The connections between insufficient sleep and adverse health were independent of energy intake and physical activity levels, indicating that sleep itself is important.”

Meet India’s Manushi Chillar – Graceful Medico who Went on to Win Miss World 2017

Posted on November 18, 2017 by Arun Kumar

India’s Manushi Chillar has finally brought India the much-required international glory that was achieved by Aishwarya Rai way back in 1994 and Priyanka Chopra in 2000.

Manushi, who represented India emerged the winner after a total of 118 contestants vied for the coveted title. Miss Puerto Rico, Stephanie Del Valle, who won the crown last year, crowned Ms chillar with 2017 crown. incidentally, Stephanie had crowned Manushi Miss India 2017 in June at Femina Miss India World pageant.

When nearer to winning the title after making it to the final 5, Manushi was asked which profession deserved the biggest salary and why. To this, the daughter of doctor parents in Haryana aptly replied:”A mother deserves the highest respect. It’s not always about cash but also the love and respect that we give to someone. My mother has been a huge inspiration to me. I think it is the job of a mother that deserves the biggest salary.”

Meet Manushi Chillar?

Daughter of doctor parents, Manushi Chillar studied at St. Thomas School in Delhi and joined the Bhagat Phool Singh Government Medical College for Women in Sonepat, Haryana before becoming Miss India 2017 in June this year. Since India did not get any crown in the last 17 years, nobody expected her to make it but the Haryana girl has finally won the crown.

Manushi Chillar went on to become Miss India in June 2017 and successfully represented India at the Miss World 2017 pageant held in China on Saturday, November 18, just one day before the nation was all set to celebrate the 100th birth anniversay of Indira Gandhi, the first woman prime Minister of India.

In an interview during the rehearsals for Miss India pageant, she had said: “The only thing I believe is certain in life is uncertainty and this is what is amazing about the pageant.” True to her spirit, she bagged the global honor.

Thank you, everyone, for your constant love, support at prayers! @feminamissindia @MissWorldLtd #MissWorld2017 This one’s for #India pic.twitter.com/kcnLV4C22P

— Manushi Chhillar (@ManushiChhillar) November 18, 2017

Pushy or laid back? Economic factors influence parenting style

Posted on October 6, 2017 by Pallavi Guha

Settling on a parenting style is challenging. Is it better to be strict or more lenient? Have helicopter parents found the right approach to guiding their children’s choices?

A new study co-authored by Yale economist Fabrizio Zilibotti argues that parenting styles are shaped by economic factors that incentivize one strategy over others.

Zilibotti and co-author Matthias Doepke, a professor of economics at Northwestern University, assert in a paper published in the journal Econometrica that economic conditions, especially inequality and return to education, have influenced child-rearing strategy.

“All parents want their children to succeed, and we argue that the economic environment influences their methods of childrearing,” said Zilibotti, the Tuntex Professor of International and Development Economics at Yale. “For instance, greater occupational mobility and lower inequality today makes an authoritarian approach less effective than generations ago. It’s not that parents spare the rod because they are more concerned about their children’s wellbeing now than they were 100 years ago. Rather, parenting strategies adapted to the modern economy.”

Zilibotti and Doepke assert that parents are driven by a combination of altruism — a desire for their children to succeed — and paternalism that leads them to try to influence their children’s choices, either by molding their children’s preferences or restricting them. These motivations manifest in three parenting styles: A permissive style that affords children the freedom to follow their inclinations and learn from their own experiences; an authoritative style in which parents try to mold their children’s preferences to induce choices consistent with the parents’ notions of achieving success; and an authoritarian style in which parents impose their will on their children and control their choices.

“There is an element of common interest between parents and children — a drive for success — but there is tension where parents care more about their children’s wellbeing as adults,” Zilibotti said. “We postulate that socioeconomic conditions drive how much control or monitoring parents exercise on their children’s choices.”

The researchers apply their model across time periods and between countries. Parenting became more permissive in the 1960s and 1970s when economic inequality reached historic lows in industrialized countries and parents could realize a return on letting children learn from their own experiences, they argue. Across countries, they document a link between parenting, on the one hand, and income inequality and return to education, on the other hand. Using the World Value Survey, where people are asked which attitudes or values they find most important in child rearing, they identify permissive parents with those emphasizing the values of imagination and independence in rearing children, whereas authoritarian and authoritative parents are those who insist on the importance of hard work and obedience, respectively. They show that parents in more unequal countries are less permissive. The same pattern emerges when they consider redistributive policies. In countries with more redistributive taxation, more social expenditure, and even stronger civil right protection, parents are significantly more permissive.

The researchers assert that their theory can help explain the recent rise of “helicopter parenting,” a version of the authoritative style in which parents seek to influence their children’s choices with a combination of persuasion and intensive monitoring. They argue that the style gained purchase in the United States as economic inequality increased, inducing a shift to more intensive parenting to strengthen children’s drive for achievement and prevent them from risky behaviors. Meanwhile, they argue, more permissive parenting remains popular in Scandinavian countries, where inequality is lower than it is in the United States.

Fifty-fifty split best for children of divorce

Posted on September 8, 2017 by Arun Kumar

Preschool children in joint physical custody have less psychological symptoms than those who live mostly or only with one parent after a separation. In a new study of 3,656 children in Sweden, researchers from Uppsala University, Karolinska Institutet and the research institute CHESS show that 3-5-year-olds living alternately with their parents after a separation show less behavioural problems and psychological symptoms than those living mostly or only with one of the parents.

The practice of joint physical custody, i.e. children living alternately and spending approximately the same amount of time in their parents’ respective homes, have increased in recent years and is more common in Sweden than in any other countries. Previous studies have shown that school children and adolescents fare well in joint physical custody. Child experts have claimed the practice to be unsuitable for young children since they are assumed to need continuity and stability in their parent relations. However, few studies of preschool children with joint physical custody have been conducted.

Based on parents’ and pre-school teachers’ estimates, the researchers compared behavioural problems and mental symptoms of 136 children in joint physical custody, 3,369 in nuclear families, 79 living mostly with one parent and 72 children living only with one parent. In this sample, joint physical custody was hence more common than living only or mostly with one parent. The symptoms were assessed using the popular “Strengths and Difficulties Questionnaire” (SDQ), and showed that both preschool teachers and parents indicated children living mostly or only with one parent to have more difficulties than those living in joint physical custody or in nuclear families. In the parental estimates, there were no significant differences between children in nuclear families and joint physical custody, while pre-school staff reported fewer symptoms of children in nuclear families.

The study is the first of its kind to show how Swedish children this young fare in joint physical custody. The assessments of children’s health from the preschool staff, in addition to those of the parents, is a considerable strength of the study. However, the study design does not allow any interpretations of causal relations. Such interpretations require knowledge of the children’s wellbeing and symptoms before parental separation.

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