STORY BYElizabeth Arnold’s due date wasn’t until close to Mother’s Day, but seven weeks before she was expected to give birth to her first daughter, the unexpected happened.
First, her water bag broke. Then when the physicians tried to induce labor, Arnold began to hemorrhage. To prevent further complications for the mother and her baby girl, Ella Rose, they had to do an emergency caesarean section.
Ella Rose weighed a little more than four pounds, but in spite
of her small size, she was healthy. Even so, her mother didn’t
want to take any chances when she became pregnant with her second
child.
The Houston resident was one of almost 500 women who enrolled in a National Institutes of Health study to test whether weekly injections of 17 alpha-hydroxyprogesterone, or 17P, a progesterone-derived hormone, prevented preterm births.
The results were so compelling that the clinical trial was halted so that all women—not just those in the study—who have a high risk of premature labor, would have the opportunity to receive the hormone therapy.
Of those who received the progesterone treatment, the risk of preterm birth before the 37th week of pregnancy was reduced by 34 percent. The preterm birth risk prior to 32 weeks was reduced by 42 percent.
“I’m a believer,” Arnold said. “Ruby was due on Jan. 12, and she came on Jan. 2. She is perfect.”
Elizabeth Arnold and children, Ella
Rose (right)
and Ruby (left).
Photo by: Meredith Raine
Dr. Susan Ramin, who led the research at The University of Texas Medical School at Houston, said mothers-to-be have an 11 percent chance of delivering a premature baby. And women who have already had a premature baby are at even greater risk – by as much as 50 percent -- of going in to preterm labor during subsequent pregnancies.
Every day, more than 1,300 babies are born too soon in the United States, according to the March of Dimes. Their early arrival puts them at greater risk of death and long-term medical complications, including lung and development disorders, than babies born between 38-42 weeks.
“We don’t fully understand why women go in to premature labor, and we don’t have good methods for stopping it,” says Ramin, director of the Maternal-Fetal Medicine division. “But we do have some very exciting news about a progesterone therapy that dramatically reduces recurrent premature birth in women who are at high risk.”
Although most women naturally produce large quantities of progesterone during pregnancy, boosting the progesterone level with injections appears to lessen the risk of preterm delivery.
Ramin, associate professor of Obstetrics, Gynecology and Reproductive Sciences, said the therapy isn’t yet covered by insurance, but physicians are offering it to mothers.
Women should begin progesterone therapy 16-20 weeks into their pregnancy and receive weekly injections until the 36th week, Ramin says. It can cost as much as $250 for the entire treatment.
Currently, patients must come to the doctor’s office for the injections, which may be an inconvenience, but Ramin expects that in the future, mothers-to-be may be able to do their own injections at home.
“This is a wonderful way to decrease the incidence of preterm births and increase the number of healthy babies who are born every day,” Ramin says.
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Dr. Susan Ramin is director of the Maternal-Fetal Medicine Division at the UT Medical School.
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Eating healthy
reverses metabolic syndrome
Dr. Tasnime Akbaraly of University College London and her colleagues were interested if healthy eating could actually turn-the-tide and reverse metabolic syndrome, which is having 3 or more of the following risk factors: excess abdominal fat; high triglycerides, hypertension, low levels of HDL the “good” cholesterol, or type 2 diabetes. Having metabolic syndrome doubles a persons’ risk of heart disease and greatly increases the odds of developing type 2 diabetes.
The researchers studied 339 British civil servants with metabolic syndrome, and how closely the adhered to the Alternative Healthy Eating Index (AHEI) to see if it could help reverse metabolic syndrome. The AHEI is a set of published nutritional guidelines by the Harvard School of Public Health in 2002 that emphasizes whole grains, fruits, vegetables and decreased red meat consumption.
Five years into the study, nearly 50% no longer had metabolic syndrome. People who followed the AHEI guidelines the closest were nearly twice as likely to have reversed their metabolic syndrome. The results of the study were published in Diabetes Care, online July 29, 2010.
Dr. Alice Lichtenstein, an expert on diet and heart health from Tufts University in Boston who was not involved in the study said, "It's not about focusing on individual components of the diet, it's really the whole package, and that becomes important because it means that if one of the components of a healthy diet is to eat more fruits and vegetables, just buying a pill saying that there's a concentrated extract of fruits and vegetables is probably not what's going to help you."
Call and make an appointment with Wellness Coach Sam Hester, CWC, CPT, LWMC, at 713-500-3327. It's confidential and free. For more information on the wellness services provided, visit UT Counseling and WorkLife Services.
