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Want to preview my latest cookbook–or simply get seven fab, fast, and healthy pregnancy recipes? After a year of developing recipes, begging my chef friends to offer their favorite healthy (but decadent!) creations, testing, eating, and working with NYC nutritionist Brooke Alpert, who contributed prego-nutrition information for the front of the book and nutritional breakdowns of each recipe, I’m proud to introduce you to the next book you should buy. Honestly, if your definition of eating well takes both health and flavor into account, you will love this book. Supercool blog Metropolitan Mama posted an interview with me last week–and is giving away a copy of The Real Deal Guide to Pregnancy to one reader who comments on the interview post before midnight on Thursday, May 29. I’ll be doing this through the remainder of my pregnancy, so be sure to subscribe to She Just Glows for monthly updates!
Megan Martire:October 14, 2014 at 7:21 pmI jst wanted to let you know how much I enjoy reading your blog!
A recent study about the flu vaccine during pregnancy has added to the continuously growing pile of evidence showing the vaccine’s safety and importance for pregnant women and their unborn babies. According to multiple medical organizations and the CDC, one of the best things you can do for your unborn baby is to offer him or her the protection of the flu vaccine. I’ve written about getting the flu vaccine during pregnancy several times, including when I got my own flu shot several months back while in my first trimester and in my lengthy myth-busting post about the flu vaccine. The worst part about these inaccurate articles is that they prey on women’s fears and increase their anxiety while encouraging women to make a riskier decision – to skip the flu shot. Let me state this in no uncertain terms: the consensus of peer-reviewed evidence about the influenza vaccination and pregnancy is that it reduces the risk of flu among pregnant women and leads to better outcomes for their unborn babies – fewer preterm births, fewer underweight babies and fewer miscarriages and fetal deaths. I only know two ways to combat the misinformation and fear-mongering in these articles: to provide accurate information for the former, and to offer an anecdote about losing a fetus while sick with influenza for the latter. The anecdote is from Johanna Holmes, a friend who became sick with the H1N1 flu while she was pregnant in 2009.
As for the research (all citations are linked to in the text), the most recent article came out just two days ago in the Canadian Medical Association Journal. But the women who were vaccinated had 25% lower odds of having a preterm birth and 27% lower odds of having a baby with a low birth weight (less than 5.5 lbs), after taking into account other differing characteristics of the women.
The second study compared 4,191 babies with or without any one of 41 different birth defects. Women who were unvaccinated during the 2009 H1N1 epidemic were 25% more likely to experience a fetal death (miscarriage after 12 weeks of pregnancy) than women who received the flu vaccine. Also, consider other studies that have found risks among pregnant women who caught the flu, such as a higher risk of hospitalization and death than the risk for those who don’t catch the flu. Have you seen the false claim that reports to the Vaccine Adverse Event Reporting System were higher for pregnant women vaccinated against the flu than for those who skipped the shot?
Another study, in JAMA in July 2012 (funded by the Danish Medical Research Council, conducted by authors with no pharma ties), looked specifically at outcomes among 53,432 babies. An April 2012 study in the American Journal of Public Health tracked 55,570 pregnant women, 42% of whom received the H1N1 flu vaccine. Another March 2013 study in Obstetrics and Gynecology compared 75,906 pregnant women who received the flu vaccine with 147,992 pregnant women who did not receive it: no differences in adverse events (including pregnancy complications) between the two groups were seen in the 42 days after immunization. Similarly, a September 2013 study in Obstetrics and Gynecology compared 74,292 flu-vaccinated pregnant women with 144,597 unvaccinated pregnant women (matched by age, location and pregnancy start date). A February 2012 study in the Canadian Medical Association Journal compared 340 Bangladeshi women who received either the flu vaccine or a pneumococcal vaccine (in the control group). A December 2013 study in Vaccine, involving 3,393 live births in the state of Georgia, found lower odds for preterm birth and underweight babies among pregnant women who received the flu vaccine compared to unvaccinated pregnant women. A July 2013 study in the European Journal of Epidemiology, involving 21,087 pregnant women, found no higher risk among women vaccinated against the flu than unvaccinated women for preterm birth, babies with low birth weight, underweight babies (small-for-gestational-age) or a low Apgar score. A May 2011 study in PLoS Medicine, involving 4,326 babies, found that newborns were 69% less likely to be born underweight and 40% less likely to be born premature during flu season if their mothers had received the flu vaccine while pregnant than if the mothers were not vaccinated against the flu. A May 2013 study in the journal Clinical Infectious Diseases, involving 3,327 babies born during the 2009 H1N1 flu season, found that pregnant women vaccinated against the flu were less likely to have preterm babies than unvaccinated women.
A December 2012 study in BJOG: An International Journal of Obstetrics and Gynaecology compared 18,612 pregnant women who received the flu vaccine to two comparison groups of women without known vaccinations. A September 2012 study in Obstetrics and Gynecology compared 8,690 pregnant women receiving the seasonal flu vaccine with 76,153 women who declined vaccination over five years (these numbers are only available in the full study, not the abstract). All these studies were mostly published within the past two years, and many (if not most) were conducted without any pharmaceutical or other industry funding.
Again you have posted a thorough and informative piece, but there was one aspect of this particular article that I found troubling. Vaccine inserts refer only to the clinical trials submitted to the FDA for the vaccine’s approval and do not include any post-licensure studies. Randomized controlled trials are lacking for this question on flu vaccine safety for pregnant women.
My sister was bullied into having flu jab in her first trimester it was reported her baby stopped growing soon after and on her most recent scan they could not find a heart beat. I would have to go back to double check, but from memory, all of these studies are either case control retrospective or observational prospective with cohorts except the one done in Bangladesh, which was an RCT (they used the pneumococcal vaccine for the control group). Another helpful thing that a couple of the studies’ researchers did was calculate separate findings during flu season and during the rest of the year. I would like to find out about the safety of Vaxigrip flu vaccine inmthe first trimester of pregnancy.
The recommendation for vaccination in the second or third trimester is not because of safety concerns (in some other countries, health authorities recommend vaccination in any trimester)but because the antibody transfer from mother to fetus increases after 28 weeks of pregnancy. Beyond that the GreenMedInfo has cherry-picked one study that found something different than the two dozen or more studies I’ve included here and have been done since.
Is It Really Possible For A Man To Experience A Sympathetic Pregnancy Along With His Wife Or Partner's Real Pregnancy?
Is it really possible for a man to experience a sympathetic pregnancy along with his wife or partner's real pregnancy? While some research suggests that Couvade syndrome (sympathetic pregnancy) is common, it isn't a recognized mental illness or disease. According to May Clinic, the symptoms of Couvade Syndrome tend to occur during the first and third trimester. Regardless of whether Couvade Syndrome -- a sympathetic pregnancy -- is "real," what is real is a man becoming a father.
Check out pregnancy mecca The Bump, which is featuring photos and instructions to recipes from Healthy Eating During Pregnancy.
Called Healthy Eating for Pregnancy and due to release in March 2011, it features 100 spectacular recipes that happen to be good for you and your growing babe, but, more importantly, are about as far as you can get from the kinds of bland, appetite-crushing options I have seen in other pregnancy health books. The chalkboard art alone took at least 20 minutes, not to mention the outfit-styling and full hair and makeup. And since being real and authentic is super important to me, I decided I’d share a much different take on the month-by-month pregnancy photos.
I'm not a mom yet (someday soon), but I am a nanny, so slot of your tips really help me out. I try to be honest and raw, even when that means posting some BAD pics of myself to get the point across.
And yet, the fear, confusion and misinformation about pregnancy and the flu shot maddeningly persists. However, articles claiming that the flu vaccine is dangerous during pregnancy continue to pop up, posted on social media or emailed to me by frightened, confused, misinformed or angry women. Some of the women I’ve seen ask about this issue are first-time moms or have already lost pregnancies, perhaps multiple times, so they are especially sensitive to anything they might do that they fear would increase miscarriage risk. A study of 12,223 women in Nova Scotia found that only 16% of pregnant women between November 2010 and March 2012 received the flu vaccine. There were too few fetal deaths to calculate risk differences among vaccinated and unvaccinated women.
Two smaller studies published in the journal Vaccine last September (both funded by the US Department of Health and Human Services) found similarly encouraging results.
These findings took into account the following differences among the women: age, number of previous children, marital status, use of nutritional supplements during pregnancy, smoking during pregnancy, previous miscarriages and eight medical conditions (asthma, high blood pressure, heart disease, kidney disease, rheumatoid arthritis, epilepsy, thyroid disease and diabetes). A study that investigated miscarriages among women who lived through the 1918 Spanish flu epidemic found a particularly high rate of losses – 1 in 10 pregnant women – that were attributed to the infection. Overall, 13% (6,989 infants) of the babies’ mothers had received the H1N1 flu vaccine. Compared to unvaxed moms, the vaccinated moms were 10% less likely to have a baby weigh below the 10th percentile, 19% less likely to have a baby weigh below the 3rd percentile, 27% less likely to give birth before 32 weeks of pregnancy and 34% less likely to have a fetal death. During the 42 days after immunization, there were no higher rates among the vaccinated women for hyperemesis (severe morning sickness), high blood pressure, pregnancy-induced high blood pressure, gestational diabetes, protein in urine or urinary tract infection. While the flu virus was circulating, 26% of the flu-vaccinated women had underweight babies compared to 45% of the control-group women.
The babies of vaccinated moms were also an average 45 grams (0.1 pounds) heavier than babies of unvaccinated moms.
Rates of underweight babies and birth defects were similar across all women, but rates for stillbirth, preterm birth and low birthweight were lower among the women vaccinated against the flu.
The researchers found no significant differences between the two groups of women in terms of major birth defects, stillbirth, fetal death or preterm birth, regardless of the trimesters when vaccinated women received their vaccines.
I think you are doing necessary work and you’ve been in my RSS feed since a friend linked to you on facebook several months ago. You are taking a calculated risk every time you get in a car, or even walk out the front door. I wish that everyone approached decisions about vaccination and other risks in our lives using evidence-based information and appropriate risk-benefit analyses. Maybe my reaction was so strong because I resent the impulse in myself to be swayed by anecdotes rather than hard facts. Many ethics boards would not approve a randomized, controlled trial on pregnant women because that would mean denying half the women in the study from the flu vaccine, which is established to protect both the mother and the fetus from the infection and from increased risk of death of the fetus. Unexplained miscarriages, stillbirths, growth restriction, disorders and other issues occur that scientists have not learned enough about to understand or prevent or treat.
I thought about changing the tagline and design part about that, actually, because I wondered if I were being sexist ?? I definitely hope dads are checking this info out too! There was another similar RCT in Bangladesh that I did not include here, but I don’t recall seeing any other RCTs in the ones I included. I mentioned the confounders in one or two of the studies I described, but I didn’t include what the confounders were for all of them. One of the studies (I don’t recall which one offhand) actually calculated findings for women who were pregnant during the traditional flu season and during the months when the flu virus was actually circulating, in addition to calculating findings during non-flu season.
I also think, given the population sizes, the effect sizes and the confounders that were included across such a large number of studies, that this collection (along with the many I didn’t include) provides a sufficient evidence base to draw broad conclusions about the fact that the flu vaccine certainly does not increase risks and may, in fact, decrease several risks (at least during a flu season) during pregnancy. So the goal is simply to give the vaccine so that the peak antibody response in the mother after vaccination coincides with the time of peak antibidy transfer.
The term for a sympathetic pregnancy is Couvade Syndrome and many couples who are expecting a baby joke about the expectant father gaining weight, eating sweets and having back pain. Further studies are needed to determine whether Couvade syndrome is a physical condition with psychological causes.
If you're a man whose partner is pregnant, take steps to manage stress and prepare for fatherhood. The second is both false and irrelevant (discussed in my flu vaccine myths post here), given that you can get a thimerosal-free (preservative-free) flu vaccine if you choose.
The first followed 1,032 pregnant Canadian women, 81 percent of whom received an H1N1 flu vaccine.
The eight defects that differed occurred in a tiny number of babies and did not reach statistical significance (so the findings were likely due to chance).
Comparisons between these babies and those not exposed to the flu vaccine found no significant differences in rates of birth defects, preterm birth or being underweight (small-for-gestational-age). Through the end of the pregnancy, rates were no higher for the vaccinated moms for protein in urine, urinary tract infection, pregnancy-induced high blood pressure, pre-eclampsia, eclampsia, bacterial inflammation of the fetal membranes, bacterial infection during childbirth, pulmonary embolism (lung blood clot) or a weak heart muscle.
The average birth weight of babies born to flu-vaccinated moms was 7 pounds, compared to an average weight of 6.6 pounds among babies born to control-group women. But frankly, if this list does not convince you of the safety, effectiveness and importance of the flu vaccine during pregnancy, and Johann’s story does not offer the same food for thought that scary, unsubstantiated flu-vaccine-caused-my-miscarriage claims offer, then I suspect no study or story will satisfy you. There is no scientific fact behind the stories, but when faced with a mourning mother and a pile of impenetrable scientific journal articles it is a hell of a lot easier to listen to the mom.
I am careful to mention the known risks of vaccination when I write about it in most of my posts, and I go into this in greater detail in the flu vaccine myths post.
Therefore, the dozens of studies I’ve referenced here and that have been done show the safety of the vaccine. What we do know is that the evidence shows flu vaccines are fortunately not associated with those issues. I curious to know if the women in these studies who did not vax and had preterm babies actually got the flu during their pregnancy. I don’t recall if the RCT did lab-confirmed flu tests (that may have been difficult in the circumstances), but lab-confirmed flu tests were not reported for the others (again, that I recall from memory at the moment. One or two reported separate findings for the months when the virus was confirmed to be circulating and the months when it wasn’t. If it specifically is recommended during the second or third trimester, I would probably wait until then, but as I noted, I have not seen evidence to show harms in the first trimester. That said, a vaccination earlier in pregnancy will still lead to improved protection for the infant versus no vaccination at all. The CDC does not have any additional information on the cases in VAERS than anyone else (except personal contact info, which would be inappropriate to pass out because it would violate HIPAA). I am currently 21 weeks pregnant and chose NOT to get the flu vaccine because there is so much negative info about it and I figured the flu was a miserable thing to have but generally harmless. Participants will take a survey that will result in being quoted in the book, be acknowledged by name, if desired, and sent a free copy.
During the 2009-2010 season, women receiving the vaccine had a slightly higher risk of preterm birth – by two days of gestation.
But using her story to bolster your position (yes, you point out is is an anecdote and that the cause of her loss was not established, but it is presented alongside journal articles both in the body of the piece and in the last paragraph) in a persuasive piece about the safety of flu vaccines is the exact same tactic used by the anti-vaccine movement. I just don’t think her story should be part of an article that is approaching the vaccine issue by rigorously looking at the science. I would need to go back and look at them all to double-check, but I expect those results would have been reported in the abstracts in any case). Many (if not most) also included marital status and chronic health condition history (diabetes, etc.). At least one of these found no difference between the vaxed and unvaxed groups in preterm birth during non-circulating months (I might have mentioned this above? Many times, they do not relate to vaccines at all — they discuss ingredients or in vitro experiments that mean nothing regarding the clinical use of vaccines in the real world. They are not fact-checked or edited — whatever is submitted remains there permanently. Brogan is a well-known anti-vaccine advocate (A friend of mine went to med school with her, and it was her anti-vaccine propaganda that led him into debunking false info about vaccines), and GreenMedInfo frequently has fear-mongering misinformation about vaccines.
I actually did not realize that it can possibly contribute to premature birth and having a 28 week preemie in the past, I am already at risk.
There were no differences in miscarriage rates or babies’ weights or lengths between the two groups. In the case of the retrospective ones, which was the majority, it’s not possible to record lab-confirmed flu cases because many of the women may not have gotten tested if they were ill.
I don’t recall seeing BMI included as frequently, and that could be a confounder that was not considered in some of the studies, though not likely for the preterm findings.
If not, I should add it), but they did find a significant reduction in preterm birth among vaxed women who were pregnant during the months the flu virus was circulating. The idea is to collect anything that happens so that if a pattern emerges, researchers can check it out.
I am kicking myself now for not researching further and I wish I had come across this post sooner. There actually was a slightly higher risk of preterm birth among those who got the vaccine – but those births occurred just an average three days earlier than in the unvaccinated group, hardly cause for concern and potentially due to chance. The best example for this that I frequently mention is the fear that many rational people have of flying when they won’t blink about driving hundreds of miles. The calculated risk is skipping the flu vaccine and leaving one’s self vulnerable to the flu, which is associated with a higher risk of miscarriage and stillbirth.
BMI is usually associated with pre-eclampsia, gestational diabetes and, in the case of obesity, heavier babies. Even if they know in their heads that the statistics of a plane crash are considerably dwarfed by the stats of car accidents (and likewise with deaths in both), they will still experience severe anxiety boarding the plane while feeling fine and normal in the car. The case control studies all matched their participants, so most of these confounders were considered in the design of the study rather than adjusted for after the fact.
For example, one scientist, just to make a point, submitted a VAERS report describing his transformation into the Incredible Hulk after getting a vaccine. Because of this known disconnect between how our emotions and our rational thought influence our decisions, I think it’s important to use both tools in helping people understand risks.
Very serious or very rare adverse events, including death, are often covered as case reports. The rarity of these case reports (and the fact that they are published since the case is unusual) is evidence itself of the rarity of the events. These stories may reach people whom remain unconvinced or confused by the data and can counter the emotional weight of the anti-vaccine movement’s stories. Occasionally, there ARE legitimate studies in those lists, and they often refer to findings that have led to changes in vaccine production, distribution, research, etc. For example, the finding of RotaShield’s link to intussusception led to its being pulled from distribution in 1999 and the development of two other rotavirus vaccines. The clinical trials for these vaccines were much larger than those for RotaShield so that any possible increased risks of intussusception would hopefully be more detectable. These are all numbers I made up for the sake of illustrating it, but you can hopefully see how VAERS data is being misused in their claim.
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