Hello and welcome to
Health for A Lifetime.
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Today, we're gonna
talk about something that
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maybe many of our
viewers have experienced
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and that is looking
forward to that first baby.
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Being excited about
that new bundle of joy
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that's coming into your home.
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Sometimes people say, Why wait?
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Maybe something
should come early.
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But, we're going to learn today
that having a baby too soon
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is really quite damaging,
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and how to avoid
that, if possible.
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Talking with us today
about that is Dr. Neil Nedley.
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Welcome, Dr. Nedley.
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Thank you. Good to be here.
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You're a friend to this program.
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Some may have just joined us,
but many times, we've talked.
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You're actually an
internal medicine specialist.
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You practice in
Ardmore, Oklahoma. - Correct.
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You see people that
have just had babies?
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Normally, it's a pediatric
type person or an OB type doctor
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that sees these types
of people that have had
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births where
there's a premature birth.
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But how would you as an internal
medicine relate to this?
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Well, I often see many of
these pregnant women in my
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internal medicine
office because they have
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internal
medicine problems. - Okay.
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And, of course, that increases
the risk of premature births.
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And so, we're trying to
do everything possible to
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prevent the premature delivery.
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So, we want to
get that mom healthy;
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all the different things
we'll talk that about today.
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Now this is a concern
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among researchers
here in America, isn't it?
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It is a concern. In fact, just
very recent studies have shown
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that it's a
growing problem in America.
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In fact, we have a
graphic that illustrates
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that US health leaders are
trying to craft a blueprint on
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how to cut the US
premature birth rate.
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The problem with it
is that so many people,
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so many kids are
being born premature now
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In fact, it's increased
by 20 percent since 1990.
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Half a million
babies are born premature
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in this country every year.
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And that means before 37 weeks.
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So it's not just
one week premature
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or two weeks premature.
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To actually get the
definition of prematurity
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you have to be more
than four weeks early.
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And, if you are more
than four weeks early,
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that increases your risk of
a host of problems later on.
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I know this isn't part of
it, but what about coming late?
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Is that a problem, too?
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Coming late can be a problem.
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Particularly if
it's over two weeks late.
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In some studies, it can increase
the risk of some problems
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However, that is not near
as common a problem in America
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as coming early; which is
the far more common problem.
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So, when they come premature,
there also is the problem of...
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Is it something
to do with weight?
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It is. Actually, if
they're coming premature,
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there actually is low birth
weight associated with that.
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And when you
have low birth weight
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then that also increases your
risk of a number of problems.
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So, let's talk,
then about premature
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birth, but more
prenatal influences.
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What kind of things
are influencing this?
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Identifying those
would be one thing.
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It may be obvious how to avoid
them if we just identify them.
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But, let's talk about those.
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Well, some of the prenatal
influences that could lead to
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premature birth are
going to be smoking, drinking,
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more in vitro fertilization.
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That's one of the
reasons why it's increased.
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The in vitro fertilization;
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particularly when you
have multiple pregnancies.
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That also increases the risk
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that prematurity is
going to come about.
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So, how does that work
with the in vitro fertilization?
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Is it not as closely...
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Is it not as firmly
grounded there in the...
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Why would that be premature?
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Well, often they're
using more than one sperm
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and more than one egg to
do the in vitro fertilizations
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so they get a pregnancy.
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And so, to increase the chance
that they'll have a pregnancy
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often there can be two or
three babies born; four or five.
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That's where you get the seven
babies born, eight babies born.
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And the more babies
that are inside the womb
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of course, the
bigger that womb gets.
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And the larger it gets, the
greater the risk that it's gonna
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try to expel those
contents before it's time.
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And then smoking and alcohol?
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How does that cause premature?
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Do you know the
mechanism of that?
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There have been studies
in regards to the mechanism.
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It's actually more
than one mechanism.
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There's over 2000
chemicals in cigarette smoke.
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Some of those
chemicals can actually
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lead to uterine contractions;
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can lead to decreased
circulation of certain portions
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of the uterus.
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One of the reasons
why fibroids of the uterus
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also can increase the
risk of premature delivery
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because of the decreased
circulation in that area
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and smoking does
affect the circulation.
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So, I'm sure second
hand smoke would as well.
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Second hand smoke
does, to a certain extent.
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So, if you're not a smoker
and you're carrying a baby
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you don't want your husband
to smoke around you either.
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Okay. And then alcohol?
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Yes. Alcohol also has a
significant role to play.
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Alcohol increases the risk
of blood pressure problems.
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A lot of people
are unaware of the fact
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that just two
ounces of alcohol a day
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is all it takes to raise
a woman's blood pressure.
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And when she
increases her blood pressure
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it increases the risk
of premature delivery.
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Okay, so, no
smoking, no drinking and
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then also watching this
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fertility things in terms
of in vitro fertilization.
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What are some other
causes of premature...
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Well, maternal obesity.
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Maternal obesity?
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That's right. And so, when
the woman is overweight, she
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increases her risk of actually
having an underweight baby.
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How does that work?
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Maternal obesity also increases
the risk of high blood pressure.
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And there's probably some other
mechanisms involved, as well,
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in that process.
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We recommend, actually
if someone is overweight and
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they're having a baby they don't
need to gain as much weight
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as someone who
is of normal weight.
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In fact, a recent obstetrics
task force looked at this
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and a person who is obese
at the time that they conceive
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they really should
only gain about 15 pounds
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during their pregnancy
or maybe a little more.
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But certainly not the 25
pounds that's recommended
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for someone who
is of normal weight
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at the time when
they get pregnant.
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Maybe there's not enough
room in there for the baby.
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They want to
get it out of there.
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Well, that could be part of
it as well as we'd talked about
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when there is more pressure
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on that it does
increase the risk of delivery.
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I saw a CAT scan, not
of the lady of course but
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looking at the
obesity of someone inside
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we see someone obese outside.
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Inside there's also a lot
of adipose tissue in there.
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A lot of adipose
tissue in there, and
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A lot of fat cells. Right.
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And if you're wearing
tight jeans on top of that
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you've increased
the pressure even more.
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Baby says, Get me out of here.
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Anything else then
in terms of premature...
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There are a host of factors that
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increase the risk
of premature delivery.
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Diabetes is one of them.
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And if the diabetes is
not controlled in the mother.
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And so checking for
gestational diabetes,
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checking those blood sugars,
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getting on the right diet so the
blood sugars don't go above 140
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an hour after
eating is an important step
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in preventing a
premature delivery.
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We don't know why they
come out early based on that.
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It's just, we need to avoid it.
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That's right. We
need to avoid it.
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So Diabetes, making sure that...
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And this happens a lot.
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When someone gets
pregnant, it just kind of
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puts them over the edge and they
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get diabetes when
they never had it before.
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So they need to get checked.
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If they have the
gene for diabetes.
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In other words, if their mother
was a diabetic, or father.
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Or maybe their mother
and father aren't old enough
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to get to diabetes yet.
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But if they have the gene
there, even among grandparents
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that really increases their
risk of gestational diabetes.
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When you say they have the gene,
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they shouldn't get genetic
testing, they just know their
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family history, is
what you're talking about.
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Yeah. If they know
their family history.
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If that is there... If
they do get gestational diabetes
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it is a true sign that
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that mother does
indeed have the gene.
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And so that means
she is going to develop
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diabetes later on in life
unless she stays normal weight,
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stays lean, stays exercising
and eats the right food
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and even if you have
the gene for diabetes
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you'll never develop diabetes
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if you're on an
ideal lifestyle program.
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Some other things
that increase the risk.
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Caffeine increases the risk.
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A study by Yale University
back in 2003 showed that if you
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drink a 10 ounce glass
or cup of coffee per day,
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it does significantly increase
the risk of preterm delivery
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as well as low
birth weight babies.
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So just one cup of
Starbucks or whatever it is..
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That's right.
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That's not
something someone who is
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pregnant or
thinking of getting pregnant
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or trying to get
pregnant should be drinking.
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Exactly.
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Was there any factor as to when
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they drank that
during the pregnancy
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in terms of heightened
risk or was it anytime?
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Particularly in the
first two trimesters
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it increases the risk.
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So at the time you get pregnant,
that's a good time to...
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Actually before
you get pregnant...
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If you're planning
on getting pregnant
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go through the
caffeine withdrawal first.
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You'll have
headaches for a couple of days
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but it'll be worth
it in the long run.
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So, basically
everything you know to be bad,
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stop doing it
before you get pregnant.
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Exactly. You would actually...
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That way your
dream can be fulfilled
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of having the perfect baby.
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Everyone wants to
have the perfect baby
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and there are ways actually of
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greatly increasing
your likelihood of having
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that perfect baby.
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Does age have anything
to do with premature births?
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Age of the mother? Yes.
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It does.
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Mothers who are over the
age of 35 when they get pregnant
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they have an increased
risk of preterm delivery.
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And even more vital
than that is mothers
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who are under the age of 16
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have a significant
risk of preterm delivery.
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In other words,
when you are over 35
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are you saying
don't try to have a baby?
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No, I'm just telling
you the statistics on that
00:11:43.92\00:11:47.27
that are associated with it.
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I think if you're
over the age of 35
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you can still have babies.
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In fact a recent study
00:11:52.78\00:11:54.26
showed that if you have
a baby and you're aged 45
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you're four times as
likely to live to age 90.
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People ought to be less
risk of living to age 90
00:12:03.48\00:12:06.67
but there might be
some sort of motivation
00:12:06.70\00:12:08.55
to see your kids and
your grandkids grow up.
00:12:08.58\00:12:11.16
So having
babies in 40's is okay,
00:12:11.19\00:12:13.86
but you would really need
to have some close prenatal
00:12:13.89\00:12:16.66
follow-up.
00:12:16.69\00:12:18.09
You need to really
do the prenatal exams.
00:12:18.12\00:12:20.31
in fact, that's one
of the risks as well.
00:12:20.34\00:12:22.20
We're talking about
risks of preterm delivery.
00:12:22.23\00:12:24.13
One of the risks is if that
girl just doesn't see the doctor
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as scheduled for
her prenatal exams.
00:12:27.90\00:12:30.74
You do need to
see your gynecologist
00:12:30.77\00:12:34.05
for those prenatal exams.
00:12:34.08\00:12:35.96
And then, of course, the
ultrasounds need to be done
00:12:35.99\00:12:38.24
making sure that the baby
00:12:38.27\00:12:39.73
is developing
normally and healthfully.
00:12:39.74\00:12:42.10
And if you do that
over the age of 35,
00:12:42.13\00:12:44.96
I think your risk can be almost
as low as someone who's 30.
00:12:44.99\00:12:48.07
Certainly it needs to be
avoided under the age of 16.
00:12:48.10\00:12:52.63
So, I'm not gonna
ask how old your wife is,
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and I'm not gonna
ask how old mine is.
00:12:55.21\00:12:56.46
But at some point, this might
be good information for them
00:12:56.49\00:12:59.48
if they want to
have another child.
00:12:59.51\00:13:00.84
Yeah, absolutely.
00:13:00.87\00:13:02.41
My wife did have a couple
of babies after the age of 35.
00:13:02.44\00:13:08.76
One in her 40's.
00:13:08.79\00:13:11.49
They were very healthy,
00:13:11.52\00:13:13.02
but she also paid
very close attention
00:13:13.05\00:13:15.39
to what I am
talking about here today.
00:13:15.40\00:13:17.45
We're talking
with Dr. Neil Nedley.
00:13:17.48\00:13:19.45
We're talking about
prenatal influences.
00:13:19.48\00:13:21.76
When we come back,
you may be saying well,
00:13:21.79\00:13:23.76
I see what I shouldn't
do and maybe that seems...
00:13:23.79\00:13:26.92
that's interesting,
but when we come back
00:13:26.93\00:13:29.45
you're gonna to see
how important it really is.
00:13:29.48\00:13:31.80
What are the
impacts on children.
00:13:31.83\00:13:35.49
When we come back,
we'll take a closer look
00:13:35.52\00:13:38.38
not only at what
the impact can be
00:13:38.41\00:13:40.18
but what we can
do to avoid problems.
00:13:40.21\00:13:42.75
So join us when we come back.
00:13:42.78\00:13:44.62