Does anyone know more about this study? I wonder if they looked at
any other possible causes than forceps and vacuum, like prone birth
position, pitocin, pain meds all of which can affect the 2nd stage.
Seems like it's such a new and surprising finding that no one really
knows how to interpret it yet.
http://www.forbes.com/forbeslife/health/feeds/hscout/2007/01/30/
hscout601416.html
One-Quarter of Vaginal Births Cause Tiny Brain Hemorrhages
01.30.07, 12:00 AM ET
TUESDAY, Jan. 30 (HealthDay News) -- In news that's sure to concern
expectant mothers everywhere, researchers are reporting that as many
as 26 percent of all babies born vaginally may experience bleeding in
the brain caused by the birthing process.
But, the researchers, from the University of North Carolina School of
Medicine, were quick to point out that these findings don't mean that
women should opt for Cesarean births, instead. These very small
hemorrhages don't cause symptoms and are likely a normal part of
delivering vaginally. And it's only because of high-tech imaging that
they've now been discovered, the study authors explained.
"This study demonstrates that intracranial hemorrhages are much more
common in newborns than expected," said one of the study's authors,
Dr. Honor Wolfe, associate professor of obstetrics and gynecology at
the University of North Carolina School of Medicine. "For parents and
obstetricians, hearing that 26 percent of babies have bleeds in the
head is frightening, and it may lead some to conclude that C-section
is safer. But, we have no evidence that these bleeds are problems
later in life, and women have delivered vaginally for centuries."
Plus, she noted, C-sections have risks as well, especially for the
mother. "I don't think patients should change plans for delivery
based on the findings in this study."
Results of the study appear in the February issue of the journal
Radiology.
Each year, about 4 million babies are born in the United States,
according to the U.S. National Center for Health Statistics.
Approximately 2.9 million of those babies are delivered vaginally,
with the remaining 1.1 million delivered by Cesarean section.
The new study, which included 88 newborns, was originally designed to
study normal brain development in infants.
The infants' brains were imaged using the latest MRI technology,
which provides very high resolution scans, according to another study
author, Dr. Keith Smith, a professor of neuroradiology.
"We need to recognize that this happens commonly after birth and
isn't indicating any abnormalities. It's not a cause for alarm. The
fact that we're seeing so much higher an incidence is a reflection of
the fact that this was done with very high resolution imaging," Smith
said.
Still, the researchers were surprised to find that so many babies had
evidence of minor bleeding in the brain.
"This finding was pretty unexpected," said Dr. John Gilmore, a study
co-author, and a professor of psychiatry.
Gilmore said the researchers went back to see if the type of delivery
-- whether forceps or vacuum extraction were used -- or the length of
labor increased the risk of hemorrhage.
"There was no association with any of these we thought might be risk
factors," said Gilmore. "It seems like it's just the process of being
born."
He added that a newborn's skull isn't yet fully formed, so it can
compress during delivery. That compression may cause small tears in
the baby's blood vessels.
But, Gilmore said there was no evidence that the small bleeds cause
any problems. To be sure, he said, they'll follow the babies'
progress over the next few years.
Dr. William Blessed is director of maternal-fetal medicine at
Providence Hospital and Medical Center, in Southfield, Mich. He
called the new research "a very good study, but with small numbers."
"I think this has probably been going on all along. I don't think the
prevalence is increasing," Blessed said, adding that the information
from this study may help doctors with liability issues. "In the past,
people always thought if there was a hemorrhage, the doctor must have
done something wrong. Now, you see you can have intracranial
hemorrhage without [cause]; it can occur in a normal birth."
Blessed said he's concerned that some patients may want to have C-
sections because of this study. He said it's important to remember
that these findings were "clinically insignificant."
C-sections, on the other hand, carry known risks because it's a major
surgery. "While the risk of complications from C-sections have
greatly diminished, there are risks. Some patients do have
complications," Blessed said.
------------------------------------------
Naomi Bar-Yam Ph.D.
Mothers' Milk Bank of New England
[log in to unmask]
617-964-6676
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