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Simple Steps Make Shots Less Scary for Kids, Nurse Says

 

By Robert Preidt

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Many children get anxious or afraid when they have to get a vaccination, but there are a number of ways that parents can make these shots easier for their kids, an expert suggests.

The first step is to explain to children in an age-appropriate way that the vaccinations help protect their health, said Rita John, director of the pediatric primary care nurse practitioner program at Columbia University School of Nursing in New York City.

"Children need to know that vaccines aren't a punishment or something negative, vaccines are something that keeps them from getting sick," John said in a Columbia news release. "When parents are anxious, they pass that fear on to their kids. The best way to talk about vaccines is to keep the conversation positive and focused on the benefits of vaccination."

Before a vaccination, you can reduce toddlers' and preschoolers' anxiety if you give them a toy medical kit so that they can give pretend shots to you or a favorite doll or other toy.

When you arrive for the shot, ask the clinician to use a numbing cream or spray to limit the pain caused by the needle. Blowing on a bubble maker or a pinwheel can help distract younger children during vaccinations, while listening to music, playing games or texting may benefit older children and teens.

"If the kids think something is going to reduce their pain, there can be a placebo effect where the technique works because they expect it to work," John explained.

"It doesn't matter so much what you use to make your child more comfortable so long as you do something that acknowledges that they may experience some pain and that they can do something to make it hurt less," she added.

Be sure to reward and/or praise children after a vaccination. For example, give stickers to younger children. "You want the final part of the experience to make kids feel like even if they suffered some momentary pain, it was worth it," John said.

"Good play preparation, a positive attitude about immunization, and bringing something to distract kids during the shots can all help make the experience better," she concluded.

Source: http://www.nlm.nih.gov

3D-printed vertebra used in spine surgery

 

By Jason Lee

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Surgeons in Beijing, China, have successfully implanted an artificial, 3D-printed vertebra replacement in a young boy with bone cancer. They say it is the first time such a procedure has ever been done.

During a five-hour operation, the doctors first removed the tumor located in the second vertebra of 12-year-old Minghao's neck and replaced it with the 3D-printed implant between the first and third vertebrae, CCTV.com reported earlier this month.

"This is the first use of a 3D-printed vertebra as an implant for orthopedic spine surgery in the world," said Dr. Liu Zhongjun, the director of orthopedics at No. 3 Hospital, Peking University, who performed the surgery.

The boy was playing football when he headed the ball and injured his neck, and it was later confirmed that he had a tumor, Minghao's mother said.

Prior to the surgery, the patient had been lying in the orthopedics ward for more than two months, and he could occasionally stand up, but only for a few minutes.

Normally, a diseased axis would be replaced by a standardized, hollow titanium tube, Liu told Reuters.

"Using existing technology, the patient's head needs to be framed with pins after surgery," as his head cannot touch the bed when he is resting for at least three months, he explained. "But with 3D printing technology, we can simulate the shape of the vertebra, which is much stronger and more convenient than traditional methods."

Five days after the surgery, Minghao still could not speak and had to use a writing board to communicate. However, doctors said at the time that he was in a good physical condition and they expected him to make a strong recovery.

Source: http://www.cbsnews.com

What Is Perfect Human Health? Google Wants to Map It

 

BY JULIANNE PEPITONE

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Google mapped the world's streets and developed self-driving cars to roam them. Now, the company wants to map something much larger: perfect human health.

Google Baseline, announced last week, will collect molecular and genetic information from an initial 175 volunteers and later thousands more. The philosophy is to focus on the genetics of health itself, rather than focus on disease.

Health research experts agree that Google brings a fresh perspective and technological expertise to the complex world of genetics. But they aren't sold on all facets of Google's approach.

"We want to understand what it means to be healthy, down to the molecular and cellular level," Google said in a press release. Google repeated the phrase "what it means to be healthy" a few times -- and that's what worries one expert.

"My immediate question is, what does Google mean by that? Healthy for a six-year-old boy, or a 75-year-old woman? You're injecting values about the range of humanity, right off the bat," said Arthur Caplan, the director of the division of medical ethics at the NYU Langone Medical Center and an NBC News contributor.

Google isn't purporting to develop a model of the singular perfect human. The goal is to analyze participants' data from to uncover "biomarkers," or patterns, that can be used to detect disease earlier.

"It's a perfectly reasonable approach, but I wouldn't do it under the 'what it means to be healthy' mission statement," Caplan said. "Those are fighting words. The mother of a child with Down's syndrome may consider her child perfectly healthy."

What's more, genetics alone doesn't provide a full picture of health or of disease, pointed out Kedar Mate, M.D., the vice president of the Institute for Healthcare Improvement, a Massachusetts-based not-for-profit.

"Genes are about 15 to 40 percent, behavioral patterns 30 to 40, socioeconomic factors 20 to 30, etc.," Mate told NBC News. "So even a wonderful genetic model is not a total picture of health."

What makes Baseline different, Google argues, is that it will "try to connect traditional clinical observations of health" like diet and other habits with genetic information.

But while Google (nor anyone) can't create the full model of perfect health, the company still brings two major advantages to the field: technological power and an outsider perspective.

"Anyone can collect 175 DNA samples," Caplan said. "But Google is a very, very powerful computational company. That's what makes it exciting."

Google's trove of technology resources and know-how could create a faster, smarter process for analyzing the links between genes and disease.

But not everyone in the field considers Google's computational power a major boost. Some genomics experts scoffed online at Google's assertion that Baseline is a "clinical research study that has never been done before."

"Frankly, anything Google does gets attention," Mate said.

"What would make it really different is Google's knowledge of so much of our behavior," he added. "If Google could take all of that and combine it with genetic information -- no other organization can offer us that."

But given what little we know about Baseline, it doesn't sound like Google is planning to do that -- at least not now. It's not clear they could, even if they wanted to.

Google declined to comment to NBC News on that point, or on the Baseline project overall. But the company told the Wall Street Journal, that use of data will be limited to medical and health purposes -- and won't be shared with insurance companies, for example.

Whether Google would -- or even could -- move to combine health data with the rest of the information it knows about our behavior, Mate insisted the nature of Google's business adds a unique element to the pursuit of health.

"You wonder if they’ll bring a fresh and different perspective, because this isn’t a stodgy academic project," Mate said. "The entry of a player like Google has the ability to stimulate the space -- and break it out of the way things have always been done."

Source: www.nbcnews.com

Daylight is best medicine for nurses

 

By Cornell University

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In a forthcoming Cornell study published in the journal Health Environments Research and Design, Rana Zadeh, assistant professor of design and environmental analysis, discovered nurses who had access to natural light enjoyed significantly lower blood pressure, communicated more often with their colleagues, laughed more and served their patients in better moods than nurses who settled for large doses of artificial light.

Letting natural light into the nurses’ workstations offered improved alertness and mood restoration effects. “The increase in positive sociability, as measured by the occurrence of frequent laughter, was … significant,” noted Zadeh in the paper.

Nurses work long shifts, during non-standardized hours. They work on demanding and sensitive tasks and their alertness is connected to both staff and patient safety. Past evidence indicates natural light and views have restorative effects on people both physiologically and psychologically. Maximizing access to natural daylight and providing quality lighting design in nursing areas may be an opportunity to improve safety though environmental design and enable staff to manage sleepiness, work in a better mood and stay alert, according to Zadeh.

“Nurses save lives and deal with complications every day. It can be a very intense and stressful work environment, which is why humor and a good mood are integral to the nursing profession,” Zadeh said. “As a nurse, it’s an art to keep your smile – which helps ensure an excellent connection to patients. A smart and affordable way to bring positive mood – and laughter – into the workplace, is designing the right workspace for it.”

Access to natural daylight, and a nice view to outside, should be provided for clinical workspace design, said Zadeh. In situations where natural light is not possible, she suggests optimizing electric lighting in terms of spectrum, intensity and variability to support circadian rhythms and work performance.

“The physical environment in which the caregivers work on critical tasks should be designed to support a high-performing and healthy clinical staff,” she said “ improving the physiological and psychological wellbeing of healthcare staff, by designing the right workspace, can directly benefit the organization’s outcomes”.

In addition to Zadeh, this study, “The Impact of Windows and Daylight on Acute-Care Nurses’ Physiological, Psychological, and Behavioral Health,” was authored by Mardelle Shepley, Texas A&M University; Cornell doctoral candidate Susan Sung Eun Chung; and Gary Williams, MSN, RN. The research was supported by the Center for Health Design Research Coalition’s New Investigator Award.

Source: www.sciencedaily.com

Many Kids Don't Have A Realistic Take On Their Weight

 

By Michelle Healy

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Nearly one-third of U.S. children and adolescents are obese or overweight, but many don't realize that they fall into that category.

According to new government statistics, approximately 30% of children and adolescents ages 8-15 years (32% of boys and 28% of girls) — an estimated 9.1 million young people — don't have an accurate read on their own weight.

About 33% of kids (ages 8–11) and 27% of teens (ages 12–15) misperceive their weight status, says the report from the National Center for Health Statistics.

Based on data collected between 2005 and 2012 from more than 6,100 kids and teens for the National Health and Nutrition Examination Survey (NHANES), the report also finds:

• 42% of those classified as obese (48% of boys; 36% of girls) considered themselves to be about the right weight.

• 76% of those classified as overweight (81% of boys; 71% of girls) believed they were about the right weight.

• 13% of those classified as being at a healthy weight considered themselves too thin (9%) or too fat (4%).

Studies have shown that recognizing obesity can be an important step in reversing what is a major health problem for U.S. children and adolescents, and it can be an important predictor of later weight-control behaviors, says Neda Sarafrazi, a nutritional epidemiologist at NCHS and lead author of the report.

"When overweight kids underestimate their weight, they are less likely to take steps to reduce their weight or do additional things to control their weight, like adopt healthier eating habits or exercise regularly," Sarafrazi says.

"On the other hand, when normal weight or underweight kids overestimate their weight, they might have unhealthy weight-control behaviors," she says.

Weight misperception varied by race and Hispanic origin, according to the report. Black and Mexican-American youths were more likely to misperceive their weight than white children. It also varied by income level and was significantly less common among higher-income families compared with lower-income families.

The report's findings are not a surprise, says Timothy Nelson, an assistant professor of psychology at the University of Nebraska-Lincoln. He was not involved in the study.

"In general, children and adolescents have a tendency to underestimate their health risks, and this certainly appears to be the case with obesity," says Nelson, who studies pediatric health behaviors. "We see a similar pattern of misperception when parents are asked about their children's weight. Parents are often unaware of the problem."

With obesity so prevalent today, it's understandable that many kids might have a skewed take on their weight, he says. "If they are surrounded by people who are overweight, they may be less likely to label their own weight as a problem."

The findings highlight the need for health professionals "to communicate with families about the child's weight," Nelson says. "This can be a tough conversation when the child is overweight, but it is critical that pediatricians help parents understand where their child stands and what steps need to be taken to get the child on a healthier track."

Source: http://www.usatoday.com

Chronic Stress Can Hurt Your Memory

 

By Serusha Govender and Sara Cheshire

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(CNN) -- Do you tend to forget things when you're stressed? Like when you're late for a meeting and can't remember where you left your car keys? Or when you have to give a big presentation and suddenly forget all your talking points seconds before you start?

There's nothing like stress to make your memory go a little spotty. A 2010 study found that chronic stress reduces spatial memory: the memory that helps you recall locations and relate objects.

Hence, your missing car keys.

University of Iowa researchers recently found a connection between the stress hormone cortisol and short-term memory loss in older rats. Their findings, published in the Journal of Neuroscience this week, showed that cortisol reduced synapses -- connections between neurons -- in the animals' pre-frontal cortex, the area of the brain that houses short-term memory.

But there's a difference between how your brain processes long-term job stress, for example, and the stress of getting into a car accident. Research suggests low levels of anxiety can affect your ability to recall memories; acute or high-anxiety situations, on the other hand, can actually reinforce the learning process.

Acute stress increases your brain's ability to encode and recall traumatic events, according to studies. These memories get stored in the part of the brain responsible for survival, and serve as a warning and defense mechanism against future trauma.

If the stress you're experiencing is ongoing, however, there can be devastating effects.

Neuroscientists from the University of California, Berkeley,found that chronic stress can create long-term changes in the brain. Stress increases the development of white matter, which helps send messages across the brain, but decreases the number of neurons that assist with information processing.

The neuroscientists say the resulting imbalance can affect your brain's ability to communicate with itself, and make you more vulnerable to developing a mental illness.

Defects in white matter have been associated with schizophrenia, chronic depression, bipolar disorder, obsessive-compulsive disorder and post-traumatic stress disorder. Research on post-traumatic stress disorder further shows that it can reduce the amount of gray matter in the brain.

The Berkeley researchers believe their findings could explain why young people who are exposed to chronic stress early in life are prone to learning difficulties, anxiety and other mood disorders.

To reduce the effects of stress, the Mayo Clinic recommends identifying and reducing stress triggers. Eating a healthy diet, exercising, getting enough sleep and participating in a stress-reduction activity such as deep breathing, massage or yoga, can also help.

Stress may harm the brain, but it recovers.

Source: www.cnn.com

Debilitating Case of Mosquito-borne Chikungunya Reported in U.S.

 

By Val Willingham and Miriam Falco

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 (CNN) -- Chikungunya -- a tropical disease with a funny name that packs a wallop like having your bones crushed -- has finally taken up residence in the United States.

Ever since the first local transmission of chikungunya was reported in the Americas late last year, health officials have been bracing for the arrival of the debilitating, mosquito-borne virus in the United States. Just seven months after the first cases were found in the Caribbean, the Centers for Disease Control and Preventionreported the first locally acquired case of chikungunya in Florida.

Even though chikungunya is not on the National Notifiable Diseases Surveillance System list, 31 states and two U.S. territories have reported cases of the disease since the beginning of the year. But only Puerto Rico and the U.S. Virgin Islands reported locally acquired cases. All the other cases were travelers who were infected in countries where the virus was endemic and were diagnosed upon returning to the United States.

That ended Thursday, when the CDC reported a man in Florida, who had not recently traveled outside the country, came down with the illness.

As of right now, the Florida Department of Health confirmed there are at least two cases. One case is in Miami Dade County and the other is in Palm Beach County.

Its arrival did not surprise the chair of the Florida Keys Mosquito Control Board.

"It was just a matter of when. We are prepared in the Keys and have been prepared for some time to deal with chikungunya," Steve Smith said. "From what I am seeing, I'm sure there are more cases out there that we don't know about. It's really a matter of time."

The CDC is working closely with the Florida Department of Health to investigate how the patient came down with the virus. The CDC will also monitor for additional locally acquired U.S. cases in the coming weeks and months.

The virus, which can cause joint pain and arthritis-like symptoms, has been on the U.S. public health radar for some time.

Usually about 25 to 28 infected travelers bring it to the United States each year. But this new case represents the first time that mosquitoes themselves are thought to have transferred the disease within the continental United States

"The arrival of chikungunya virus, first in the tropical Americas and now in the United States, underscores the risks posed by this and other exotic pathogens," said Roger Nasci, chief of CDC's Arboviral Diseases Branch. "This emphasizes the importance of CDC's health security initiatives designed to maintain effective surveillance networks, diagnostic laboratories and mosquito control programs both in the United States and around the world."

The virus is not deadly, but it can be extremely painful, with symptoms lasting for weeks. Those with weak immune systems, such as the elderly, are more likely to suffer from the virus' side effects than those who are healthier. About 60% to 90% of those infected will have symptoms, says Nasci. People infected with chikungunya will often have severe joint pain, particularly in their hands and feet, and can also quickly get very high fevers.

The good news, said Dr. William Schaffner, an infectious diseases expert with Vanderbilt University in Nashville, is that the United States is more sophisticated when it comes to controlling mosquitoes than many other nations and should be able to keep the problem under control.

"We live in a largely air-conditioned environment, and we have a lot of screening (window screens, porch screens)," Shaffner said. "So we can separate the humans from the mosquito population, but we cannot be completely be isolated."

Mosquito-borne virus worries CDC

Chikungunya was originally identified in East Africa in the 1950s. Then about 10 years ago, chikungunya spread to the Indian Ocean and India, and a few years later an outbreak in northern Italy sickened about 200 people. Now at least 74 countries plus the United States are reporting local transmission of the virus.

The ecological makeup of the United States supports the spread of an illness such as this, especially in the tropical areas of Florida and other Southern states, according to the CDC.

The other concern is the type of mosquito that carries the illness.

Unlike most mosquitoes that breed and prosper outside from dusk to dawn, the chikungunya virus is most often spread to people byAedes aegypti and Aedes albopictus mosquitoes, which are most active during the day, which makes it difficult to use the same chemical mosquito control measures.

These are the same mosquitoes that transmit the virus that causes dengue fever. The disease is transmitted from mosquito to human, human to mosquito and so forth. A female mosquito of this type lives three to four weeks and can bite someone every three to four days.

Shaffner and other health experts recommend people remember the mosquito-control basics:

-- Use bug spray if you are going out, especially in tropical or wooded areas near water.

-- Get rid of standing water in empty plastic pools, flower pots, pet dishes and gutters to eliminate mosquito breeding grounds.

-- Wear long sleeves and pants.

Source: www.cnn.com


3 More Diagnosed With Rare Plague in Colorado

 

By Reuters

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Three more people in Colorado have been diagnosed with the plague after coming in contact with an infected dog whose owner contracted a life-threatening form of the disease, state health officials said on Friday.

In all, four people were infected with the disease from the same source, the Colorado Department of Public Health and Environment said in a statement.

Last week the department said a man in an eastern Colorado county whose dog died of the plague had been diagnosed with pneumonic plague, a rare and serious form of the disease.

The man remains hospitalized, but authorities have not released his condition.

The three people in the latest reported cases had "mild symptoms" and have fully recovered after being treated with antibiotics, the department said, adding that they are no longer contagious.

Two of the patients in the new cases contracted pneumonic plague, the department said.

Pneumonic plague is the only form of the disease that can be transmitted person-to-person, usually through infectious droplets from coughing.

The bacteria that causes plague occurs naturally in the western United States, primarily in California, New Mexico, Arizona and Colorado, according to the U.S. Centers for Disease Control and Prevention.

The infected canine in Colorado likely contracted the disease from prairie dogs or rabbits, which are the primary hosts for fleas that carry the bacteria.

When an infected animal dies, the fleas spread the disease when they find another host.

Colorado has seen a total of 12 cases of humans infected with the plague over the last decade, said Jennifer House, the department's public health veterinarian.

"We usually don't see an outbreak like this related to the same source," House said.

Colorado had not had a confirmed human case of pneumonic plague since 2004, she said.

Source: http://www.foxnews.com/health

Hearing Aid Evolution Unveils What The World Sounds Like In '3-D'

 

By NPR Staff

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As hearing aid technology has improved, so has health reporter Kathleen Raven's confidence.

When she was 5 years old, she found out she had a hearing problem. Complications during her birth led to damage in her inner ear.

"I couldn't hear water dripping from a faucet. I couldn't hear crickets on a summer night," she tells NPR's Kelly McEvers. "I couldn't hear sirens, couldn't hear fire alarms in our school fire drills, so I did a lot of watching other people."

The diagnosis was moderate to severe loss of high- and low-frequency hearing. When it comes to speech, certain sounds are out of range for her. Sounds like "ch," "sh" and "th" blend together.

Raven says she reads lips "religiously," but when she can't see a person's lips, she can understand maybe every third word — that is, without a hearing aid.

She got her first hearing aids — a large, clunky set — back when she was 5 in 1993.

"They were about 2 inches long and very thick, and they connected to a very large ear mold inside my ear," she says. "They call them flesh-colored, but they're not the color of anyone's flesh." Her young classmates teased her.

But the technology kept changing. Every few years, her parents would shell out $4,000 to $5,000 on each new device. By the time she got to high school, she had her first completely inside-the-ear hearing aid. That changed everything.

"I just became more confident walking into crowds. I didn't try to hide, I didn't arrange my hair to cover my ears. I started being more talkative, going out with my friends more," says Raven. "I didn't realize how much that fear had impacted me until I got completely in-the-ear hearing aids."

She went on to college and started pursuing her dream of reporting.

"I encountered a few raised eyebrows along the way," she says. "Why do you want to make a living of hearing people when that's a challenge for you?"

She pushed past the skeptics and became a reporter. Today she writes about oncology forBioPharm Insight.

As years passed and the technology progressed, Raven thought her hearing had maxed out. But with each upgrade, she discovered more sounds. Two years ago, she received her latest pair, which cost $7,000.

When her audiologist put them in her ears, she heard an unfamiliar noise. "I just happened to smack my lips together, like you're tasting something," she recalls. "It's just such a simple sound, but it was earth-shattering."

Her audiologist put on Beethoven, and she heard new instruments and trills. "It was like seeing the world in 3-D, or hearing the world in 3-D for the first time," Raven says.

These latest hearing aids are basically invisible. Even still, now she tells people about her hearing loss.

"Five years ago, I still was not ever telling people unless it was absolutely necessary. And now I do work it into conversation in the first five minutes or so," she says. If she needs to ask someone to repeat something, she'll just add, "I have a hearing problem."

"That phrase was impossible for me to say for the first 20 years of my life," Raven says. "Now I think it's very important for hearing loss to be accepted for younger people, of course, and also for older people."

Source: npr.org

Overweight and Pregnant

 

Pregnancy, or the desire to become pregnant, often inspires women to take better care of themselves — quitting smoking, for example, or eating more nutritiously.

But now many women face an increasingly common problem: obesity, which affects 36 percent of women of childbearing age. In addition to hindering conception, obesity — defined as a body mass index above 30 — is linked to a host of difficulties during pregnancy, labor and delivery.

These range from gestational diabetes, hypertension and pre-eclampsia to miscarriage, premature birth, emergency cesarean delivery and stillbirth.

The infants of obese women are more likely to have congenital defects, and they are at greater risk of dying at or soon after birth. Babies who survive are more likely to develop hypertension and obesity as adults.

To be sure, most babies born to overweight and obese women are healthy. Yet a recently published analysis of 38 studies found that even modest increases in a woman’s pre-pregnancy weight raised the risks of fetal death, stillbirth and infant death.

Personal biases and concerns about professional liability lead some obstetricians to avoid obese patients. But Dr. Sigal Klipstein, chairwoman of the committee on ethics of the American College of Obstetricians and Gynecologists, says it is time for doctors to push aside prejudice and fear. They must take more positive steps to treat obese women who are pregnant or want to become pregnant.

Dr. Klipstein and her colleagues recently issued a report on ethical issues in caring for obese women. Obesity is commonly viewed as a personal failing that can be prevented or reversed through motivation and willpower. But the facts suggest otherwise.

Although some people manage to shed as much as 100 pounds and keep them off without surgery, many obese patients say they’ve tried everything, and nothing has worked. “Most obese women are not intentionally overeating or eating the wrong foods,” Dr. Klipstein said. “Obstetricians should address the problem, not abandon patients because they think they’re doing something wrong.”

Dr. Klipstein is a reproductive endocrinologist at InVia Fertility Specialists in Northbrook, Ill. In her experience, the women who manage to lose weight are usually highly motivated and use a commercial diet plan.

“But many fail even though they are very anxious to get pregnant and have a healthy pregnancy,” she said. “This is the new reality, and obstetricians have to be aware of that and know how to treat patients with weight issues.”

The committee report emphasizes that “obese patients should not be viewed differently from other patient populations that require additional care or who have increased risks of adverse medical outcomes.” Obese patients should be cared for “in a nonjudgmental manner,” it says, adding that it is unethical for doctors to refuse care within the scope of their expertise “solely because the patient is obese.”

Obstetricians should discuss the medical risks associated with obesity with their patients and “avoid blaming the patient for her increased weight,” the committee says. Any doctor who feels unable to provide effective care for an obese patient should seek a consultation or refer the woman to another doctor.

Obesity rates are highest among women “of lower socioeconomic status,” the report notes, and many obese women lack “access to healthy food choices and opportunities for regular exercise that would help them maintain a normal weight.”

Nonetheless, obese women who want to have a baby should not abandon all efforts to lose weight. Obstetricians who lack expertise in weight management can refer patients to dietitians who specialize in treating weight problems without relying on gimmicks or crash diets, which have their own health risks.

Weight loss is best attempted before a pregnancy. Last year, the college’s committee on obstetric practice advised obstetricians to “provide education about possible complications and encourage obese patients to undertake a weight-reduction program, including diet, exercise, and behavior modification, before attempting pregnancy.”

An obese woman who becomes pregnant should aim to gain less weight than would a normal-weight woman. The Institute of Medicine suggests a pregnancy weight gain of 15 to 25 pounds for overweight women and 11 to 20 pounds for obese women.

Although women should not try to lose weight during pregnancy, “a woman who weighs 300 pounds shouldn’t gain at all,” Dr. Klipstein said. “This is not harmful to the fetus.”

Dr. Klipstein also noted that obesity produces physiological changes that can affect pregnancy, starting with irregular ovulation that can result in infertility.

Obese women are more likely to have problems processing blood sugar, which raises the risk of birth defects and miscarriage. There is also a greater likelihood that their baby will be too large for a vaginal delivery, requiring a cesarean delivery that has its own risks involving anesthesia and surgery.

The babies of obese women are more likely to develop neural tube defects — spina bifida and anencephaly — and to suffer birth injuries like shoulder dystocia, which may occur when the infant is very large.

High blood pressure, more common in obesity, can result in pre-eclampsia during pregnancy, which can damage the mother’s kidneys and cause fetal complications like low birth weight, prematurity and stillbirth.

It is also harder to obtain reliable images on a sonogram when the woman is obese. This can delay detection of fetal or pregnancy abnormalities that require careful monitoring or medical intervention.

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