Newly Pregnant Smokers Have a 15-Week Window to Quit

(HealthDay News) -- Pregnant women who quit smoking before the 15th week of pregnancy reduce their risk of premature birth and having small babies to that of nonsmoking women, a new study finds.

It's known that smoking during pregnancy increases the risk of miscarriage, ectopic pregnancy, premature birth, small babies, stillbirth and neonatal death, but no study until now has determined whether stopping smoking in early pregnancy reduces the risks of small babies and premature births, the study authors said.

"Pregnant women who smoke should be encouraged and assisted to become smoke-free early in pregnancy," said lead researcher Dr. Lesley McCowan, an associate professor of obstetrics and gynecology at the University of Auckland in New Zealand.

Women who don't quit smoking by 15 weeks are three times more likely to give birth prematurely and twice as likely to have smaller babies, compared to women who stopped smoking, McCowan said.

The findings were published in the March 27 online issue of BMJ.

For the study, McCowan's team collected data on 2,504 pregnant women. Eighty percent did not smoke, 10 percent had quit smoking and 10 percent were current smokers.

There was no difference in the rate of spontaneous premature birth between women who did not smoke and those who had stopped by week 15 (4 percent vs. 4 percent). The same was true for having smaller babies (10 percent vs. 10 percent), the researchers found.

However, women who continued to smoke had higher rates of spontaneous preterm birth than woman who quit (10 percent vs. 4 percent) and higher rates of smaller babies (17 percent vs. 10 percent).

The study also found that women who stopped smoking weren't more stressed than women who continued to smoke, McCowan noted.

"Health professionals who care for pregnant women need to ask about smoking, advise about the importance of stopping, and, where possible, refer for extra support early in pregnancy to assist women to become smoke-free," she advised.

Dr. Richard Frieder, an associate clinical professor of obstetrics and gynecology at the University of California, Los Angeles David Geffen School of Medicine, said the study authors didn't explain whether this difference in low birth weight and gestational age at delivery actually translates into a measurable difference in newborn health.

"We assume this to be true, but there was only about a half pound difference in birth weight and six days difference in gestational age. These numbers are not very impressive that one would think a big difference in neonatal health would be achieved. Still, we should assume that a half pound and six days more of gestation is better and that we should strive to help women stop smoking," he said.

There are other big issues at play when it comes to babies, women and cigarette smoke, Frieder added.

"Babies that live in 'smoking homes' have a much higher risk of respiratory ailments, such as asthma and pneumonia and SIDS. In addition, women are more susceptible to the cancer-causing effects of cigarette smoke than men. The tobacco industry specifically targets women, despite this well-known fact," he said.

More information
For more on smoking and pregnancy, visit the American Lung Association.

Health Tip: Check Your Baby's Feet

(HealthDay News) -- A baby's feet grow quickly. During the infant's first year, it's important to check the feet regularly to be sure they are developing normally.

The American Podiatric Medical Association offers these suggestions:

• Examine your baby's feet carefully. Report anything that looks unusual to your pediatrician.
• Allow the baby's feet to move. Let baby lie on his or her back without a blanket or cover, to allow the feet to kick.
• Don't wrap or cover your baby's feet tightly -- leave covers loose so that your baby can move the feet freely.
• Move your baby frequently, and don't let him or her stay in the same position for too long. Frequent position changes put less strain on the legs and feet.

Musicians' Brain Waves Are Also in Tune

(HealthDay News) -- When they play together, musicians' brain waves harmonize along with the music, according to new European research.

They analyzed electrical activity in the brains of eight pairs of guitarists as they played a short jazz-fusion melody together up to 60 times.

The study found that brain-wave similarities within and between the musicians' brains increased as they listened to the beat of a metronome as they prepared to play, and also when they actually began playing together.

As expected, the frontal and central regions of the guitarists' brains showed high synchronization. But the temporal and parietal regions also showed high synchronization in at least half the pairs of musicians. These regions may be involved in the processes involved in the coordinated action between the guitarists, or in enjoying the music, the researchers suggested.

"Our findings show that interpersonally coordinated actions are preceded and accompanied by between-brain oscillatory couplings," said study author Ulman Lindenberger of the Max Planck Institute for Human Development in Berlin.

The findings didn't show whether the brain synchronization occurs first and causes the coordinated brain-wave readings, or whether it occurs in response to the beat of the metronome/music, and as the musicians track each others' movements and music.

The study, published in the journal BMC Neuroscience, is the first to analyze musicians' brain waves as they play together, the authors said.

More information
There's more on how the brain works at the University of Washington.

Children's Bath Products Contain Contaminants

(HealthDay News) -- Many baby and child-care products contain the chemicals formaldehyde and 1,4-dioxane, both of which have been linked to cancer and various skin conditions, a new report contends.

But the chemicals aren't listed on the labels of bubble bath, shampoo and other common products, according to the report from the Campaign for Safe Cosmetic Use.

"Companies can obviously do better, and we need to demand that they do better," said Stacy Malkan, co-founder of the Campaign for Safe Cosmetic Use and co-author of the report, released Thursday. "Many companies are already making great products that don't have any of these chemicals [and] many companies in the natural products industry have reformulated to get rid of that problem. We also know many companies are using preservatives that don't use formaldehyde."

According to the authors, the report, called No More Toxic Tub, is the first to document contamination of children's products with these chemicals. The Environmental Working Group was involved in the analyses.

Both formaldehyde and dioxane are considered "contaminants," Malkan said.

A contaminant "is a chemical that is not intentionally added to the product but is a byproduct," she said. "Those are all exempt from labeling laws ... Companies don't even have to know themselves."

Dioxane is a byproduct of chemical processing and formaldehyde is released from some of the chemicals that are used as preservatives, Malkan said.

John Bailey is chief scientist for the Personal Care Products Council, a national trade association for the cosmetic and personal care products industry. Responding to the report, he said, "These are issues that have been around for many, many years, so it's not new news. The thing that impressed me was the low levels of dioxane that were found in these products, which indicates to me that the industry is doing its job in keeping this potential contaminant down to a low level."

Bailey also said there were wasn't enough information in the report to gauge how accurate the determinations of formaldehyde levels were.

Malkan and her co-authors tested 48 bubble baths, shampoos and other baby and children's products for dioxane and 28 of those products for formaldehyde. The testing was done by an independent laboratory, Analytical Sciences in Petulama, Calif.

Among their findings:

• Almost two-thirds of the 28 products contained both chemicals, including Johnson's Baby Shampoo and Huggies Naturally Refreshing Cucumber & Green Tea Baby Wash.
• Eighty-two percent of products tested contained formaldehyde; the highest levels were found in Baby Magic Baby Lotion.
• American Girl shower products had the highest levels of dioxane among products tested.
  "The good news is that there are great products without any of these chemicals," Malkan said. "The challenge is you have to do some research to find them. It's not a simple matter of looking at the label."

According to Malkan, the U.S. Department of Agriculture "organic seal" indicates that none of these chemicals are present.

"The best advice for consumers is that simple is better, products with fewer ingredients overall," she said. "There are things consumers can do to make better choices at the store but we also need to change regulations and require companies to list all ingredients in the products and to make the safest products they can, especially products for babies."

Harmful chemicals and contaminants in children's products is a subject of continuing controversy. Earlier this week, it was announced that baby bottles made with the controversial chemical bisphenol A (BPA) will no longer be sold in the United States by the six largest manufacturers of the products.

BPA, which is found in a wide range of products, mimics the hormone estrogen and may disrupt the body's endocrine system. The chemical poses a particular threat to fetuses, infants and children because it can interfere with cell function when their bodies are still developing, public health experts say. The chemical has been linked with diabetes, heart disease, cancer and developmental delays in children.

More information
Get more information on what's in a product, or information on products containing no chemicals at all, at the Environmental Working Group's Skin Deep Database.

Most Insured Adults Worry About Health Care Costs: Poll

(HealthDay News) -- More than three-quarters of adult Americans who have health insurance say they still worry about paying more for their medical care, and nearly 50 percent say they're "very" or "extremely" worried about the issue, a new Harris Interactive/HealthDay poll shows.

More than half (57 percent) of those polled said they feared losing their health insurance sometime in the future, which may explain another key finding in the poll -- sizeable numbers of Americans said they're skipping doctor visits or not getting prescriptions filled to save money.

Middle-aged Americans -- people too old to be blasé about their health but too young to be covered by Medicare -- seemed most worried about paying their health care bills. Among insured individuals aged 45 to 64, a full 84 percent said they were concerned that rising health care costs would exceed their ability to pay.

Only 8 percent of all insured Americans polled were "not at all worried" about getting health care coverage.

"Many are, in fact, not filling prescriptions, skipping a doctor's visit, not following up on something that was recommended by the doctor, taking a medication less or pill-splitting, doing without dental care," said Humphrey Taylor, chairman of The Harris Poll.

He added that with the economy in a tailspin and many Americans losing their employer-based health insurance, the problem may only get worse. "If the number of uninsured rises sharply, one would expect to see these numbers increase," Taylor said.

One consumer advocate wasn't surprised by the results of the poll, which included 2,078 adults surveyed between Feb. 25 and 27.

"Even for people who have insurance, increasingly, the costs have been shifted to them -- and those costs have risen," said Carol Pryor, policy director at The Access Project, a nonprofit group dedicated to making health care available to more Americans. More and more, she added, insured Americans are paying higher deductibles and co-pays, stretching their ability to get proper medical care.

Pryor agreed with Taylor that the situation is only likely to get worse, since "more people are becoming uninsured as a result of the economic meltdown."

Some other key findings from the poll:

78 percent of adults with health insurance worry about paying more for their medical care.
Nearly two-thirds (65 percent) of all insured adults say they're worried about how they can afford to pay for medical care and prescription drugs, with that number rising to 76 percent among people aged 45 to 54. Even among those aged 65 and over -- most of whom are eligible for Medicare -- 62 percent say they worry about paying for the care they need.
Over the past year, one in five insured adults skipped filling a prescription because of the cost. That number jumped to 30 percent for those without insurance.
Similarly, cost concerns led 24 percent of the insured and 51 percent of the uninsured to forgo seeing a doctor for a specific medical problem. Twenty-one percent of the insured and 33 percent of the uninsured didn't get a recommended follow-up test or treatment for the same reason.
Trying to cut down on medical expenses, 14 percent of the insured and 19 percent of the uninsured took a medication at a lower dose than that recommended by a doctor.
Dental care took the biggest hit: 51 percent of the uninsured and 30 percent of the insured skipped necessary dental care over the past year due to financial concerns.
Forgoing care to save costs over the short term may not save costs over the long term, the experts warned. "Some things do go away on their own over time," Pryor said. "But there are a lot of conditions that get worse if they aren't treated, and they then require more expensive care later. So it's definitely a gamble."

Taylor noted that the statistics on the percentage of Americans skipping needed care have remained about the same since 2007, when Harris first asked these types of questions. That may seem odd given the recent downturn in the economy, he added. But, he noted that even if a few million Americans lose their health insurance, that's still only 2 percent of the adult population -- not enough to show up in this type of survey.

The new poll results come on the heels of a report released Wednesday by the nonprofit advocacy group Families USA. It found that a third of Americans under the age of 65 -- nearly 87 million people -- went without health care coverage at some point over the past two years.

The most recent U.S. government statistics suggest that 16 percent of all adults (including those 65 and older) have no health insurance. And a Commonwealth Fund report published last June found that the number of "underinsured" -- people who have insurance that doesn't fully meet their health care needs -- rose by 60 percent between 2003 and 2007.

The issue gained momentum in the nation's capitol last Thursday, when President Barack Obama convened a long-anticipated White House summit on health care reform. The Associated Press reported that Obama made a point of bringing a wide range of views to the table -- voices representing the insurance industry, patient groups, physicians and even those advocating a single-payer system.

"Every voice has to be heard. Every idea must be considered," Obama said during the summit. "The status quo is the one option that is not on the table."

According to Pryor, one item that should be up for discussion in Washington is the plight of the underinsured.

"Covering the uninsured is only part of the problem," she said. "Unless reform includes adequate, comprehensive and affordable coverage, just having insurance will not be protection -- either from facing barriers to care or concern over one's financial stability. And after all, those two things are the function of insurance."

More information
There's more on the underinsured in America at The Commonwealth Fund.

Health Tip: Understanding Antibiotic Resistance

(HealthDay News) -- Antibiotic resistance occurs when bacteria mutate and make certain medications ineffective in preventing bacterial infections.

The U.S. Department of Health and Human Services offers these suggestions for preventing antibiotic-resistant infections:

• Talk to your doctor about whether you actually need an antibiotic to treat a particular illness.
• Don't take antibiotics when they are not helpful. For example, antibiotics will not treat infections caused by viruses, including the common cold and the flu.
• Always take antibiotics as prescribed by your doctor. Don't skip any dose, and don't stop taking them early, even if you feel better.
• Never "save" antibiotics to take later. Never re-use them for a different illness.
• Never take an antibiotic that was prescribed to another person.

Risk Score May Predict Abnormal Heart Rhythm

(HealthDay News) -- Weighing a combination of risk factors could help doctors predict which patients are the most likely to develop atrial fibrillation, a new study suggests.

To that end, the researchers have developed a risk score that might one day help prevent what has become the most common type of abnormal heart rhythm in the United States, affecting about 2.2 million people.

"We know a lot about the prevention of many different types of vascular disease, but there has been very little attention paid to preventing AF," said lead researcher Dr. Emelia Benjamin, a professor of medicine and epidemiology at Boston University School of Medicine.

But attention might be warranted, since the condition is on the increase in the United States. By 2050, almost 16 million Americans will have AF, Benjamin said. This dramatic increase is partly due to people living longer, so they are more likely to get diseases associated with aging. In addition, people with heart disease are living longer, she explained.

The condition causes the upper chambers of the heart to beat erratically, which hinders the heart's ability to pump blood. It can increase the risk of stroke, heart failure and dementia, and although it can be controlled with medication or surgical procedures, there is no way yet to keep it from developing, according to the American Heart Association.

The risk factors for AF are known, but they tend to be looked at one at a time, and there has been no way of predicting an individual's risk for the disease, Benjamin said. "We developed a risk score for new-onset AF that would work in a doctor's office, or a person could use it to figure out their risk of AF," she said.

The risk factors for AF include older age, being male, being overweight, hypertension, having a heart murmur and a history of heart failure, Benjamin said. "These have previously been described, but not put together in a risk score," she said.

The report is published in the Feb. 28 issue of The Lancet.

For the study, Benjamin's team, which included Dr. Renate Schnabel from the Johannes Gutenberg-University in Mainz, Germany, collected data on 4,764 people who participated in the Framingham Heart Study. These individuals were aged 45 to 95 and did not have AF. The selection of people for the study was made from examinations done between June 1968 and September 1987.

Over 10 years of follow-up, 10 percent of the people developed AF. The strongest factors that predicted the risk of developing AF were age, sex, weight, high blood pressure, being treated for high blood pressure, heart murmur and heart failure. In addition, the time between the P and R waves (PR interval), as seen on an electrocardiogram, was also a significant predictor of AF, the researchers found.

The risk of AF varied with age. Those over 65 were more than 15 times more likely to develop AF than people under 65, the researchers noted.

This risk score may help doctors and patients determine the risk for AF, Benjamin said. More important, this risk score might help doctors develop a way to prevent AF, she said.

"Before you can prevent something, you have to know how to predict it," Benjamin said. This risk score will be useful first to help patients understand their risk, second to provide information for clinical trials, and third to evaluate other ways of predicting AF, she said.

Dr. David Brieger, an associate professor from Concord Hospital at the University of Sydney in Australia and author of an accompanying journal comment, said this study could be a first step in finding a way to prevent AF.

"It may be possible to identify strategies, pharmacologic and others such as lifestyle, to prevent the onset of atrial fibrillation in high-risk patients," Brieger said.

Atrial fibrillation is a potentially disabling condition that is increasing in frequency and placing an increased burden on health care resources, Brieger noted. "Preventing this condition would have immense value. Identifying patients at high risk of developing the condition is an important initial step in this process," he added.

Dr. Gregg C. Fonarow, a professor of cardiology at the University of California, Los Angeles, said it is not clear how this risk score would change clinical practice.

"While helpful from a research standpoint, the potential clinical utility of this risk score requires validation in other populations and further study," Fonarow said. "It remains untested whether detection of increased risk of AF will result in any change in care or improve clinical outcomes."

More information
For more about atrial fibrillation, visit the American Heart Association.