Pregnant women are three times more likely to suffer from severe morning sickness if their mothers did, say Norwegian researchers.

Around 2% of women suffer excessive nausea and vomiting in pregnancy – known as hyperemesis gravidarum – which can require hospital treatment.

But a study of 2.3 million births showed a threefold higher rate in those whose mothers had the condition.

Experts said the results could help women better understand their risk.

Hyperemesis is defined as excessive sickness which starts before the 22nd week of pregnancy and in its most serious form it can lead to dehydration and weight loss because women cannot keep food or water down.

It is the most common cause of admission to hospital in early pregnancy and can be a cause of low birth weight and premature birth.

The researchers said that previous studies have attributed the condition to "psychological causes".

They analysed birth records, which included information on pregnancy complications, from 1967 to 2006.

It found the daughters of women who had the condition during their pregnancy had a 3% risk compared with 1% in those whose mothers did not have it.

But there was no increased risk to the female partners of sons whose mothers had suffered from the illness.

Genes

The researchers said although the results suggest a genetic link between mothers and daughters, it is also possible that there are lifestyle or environmental factors shared between mother and daughter that increase the risk.

Writing in the British Medical Journal, they said the study "shed a new light" on the causes of hyperemesis in pregnancy.

"It might lead to a better appreciation of the underlying biology," they added.

Dr Catherine Nelson-Piercy, a consultant obstetric physician at Guy’s and St Thomas’ Foundation Trust in London, said that better understanding of the genetic risks of hyperemesis may help clinicians when counselling women about the risk of recurrence in future pregnancies.

She said many women were undertreated because of the legacy of thalidomide – a drug given for morning sickness in the 1960s which caused birth defects – despite the availability of safe drugs.

"It can be extremely debilitating, women can’t work, can’t look after their families and they need to be admitted to hospital.

"It is safe to take anti-sickness drugs and it’s better for the baby and the pregnancy to treat this condition than let the woman get very severely ill and risk complications."

Patrick O’Brien, spokesman for the Royal College of Obstetrics and Gynaecology, said the study added to growing evidence that many conditions in pregnancy, such as diabetes or high blood pressure, were linked to a "genetic predisposition".

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Light exercise during pregnancy may improve the future health of a child by controlling weight in the womb, New Zealand and US researchers say.

Overweight or obese mums are more likely to have larger babies which could be at higher risk of health problems later in life.

A study of 84 first-time mothers found exercise was associated with slightly lighter babies.

UK guidelines recommend regular light exercise for pregnant women.

The rising weight of the UK population over the years has led to a rise in the number of overweight mothers.

There is increasing evidence that the future metabolism of a child may be influenced by its environment in the womb, and that babies who are relatively heavy for their length may be more likely to be obese in future years.

Official guidance in the UK tells doctors to encourage women not to overeat during pregnancy, and to, wherever possible, take light exercise on a regular basis.

The joint study between the University of Auckland and Northern Arizona University recruited pregnant women, half of whom were asked to use exercise bikes for five 40 minute sessions each week.

They were asked to maintain the programme until at least the 36th week of pregnancy.

Extra fat

On average, the exercising women had babies who were no shorter than their non-exercising counterparts, but who were 0.32 lb (143 grams) lighter on average.

This suggested that the regime did not stunt growth in the womb, but reduced the amount of extra fat laid down by the babies.

In addition, the exercise did not appear to interfere with the natural changes in the mother’s response to the hormone insulin, a necessary mechanism in pregnancy to make sure the foetus is properly nourished.

The findings are published in the Journal of Clinical Endocrinology & Metabolism.

Dr Paul Hofman, who led the study, said: "Given that large birth size is associated with increased risk of obesity, a modest reduction in birth weight may have long-term health benefits for offspring by lowering this risk later in life."

Dr Anne Dornhorst, who specialises in research into the metabolism of pregnant women, said that it was becoming clear that exercise during pregnancy could aid the health of mother and child.

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Light exercise during pregnancy may improve the future health of a child by controlling weight in the womb, New Zealand and US researchers say.

Overweight or obese mums are more likely to have larger babies which could be at higher risk of health problems later in life.

A study of 84 first-time mothers found exercise was associated with slightly lighter babies.

UK guidelines recommend regular light exercise for pregnant women.

The rising weight of the UK population over the years has led to a rise in the number of overweight mothers.

There is increasing evidence that the future metabolism of a child may be influenced by its environment in the womb, and that babies who are relatively heavy for their length may be more likely to be obese in future years.

Official guidance in the UK tells doctors to encourage women not to overeat during pregnancy, and to, wherever possible, take light exercise on a regular basis.

The joint study between the University of Auckland and Northern Arizona University recruited pregnant women, half of whom were asked to use exercise bikes for five 40 minute sessions each week.

They were asked to maintain the programme until at least the 36th week of pregnancy.

Extra fat

On average, the exercising women had babies who were no shorter than their non-exercising counterparts, but who were 0.32 lb (143 grams) lighter on average.

This suggested that the regime did not stunt growth in the womb, but reduced the amount of extra fat laid down by the babies.

In addition, the exercise did not appear to interfere with the natural changes in the mother’s response to the hormone insulin, a necessary mechanism in pregnancy to make sure the foetus is properly nourished.

The findings are published in the Journal of Clinical Endocrinology & Metabolism.

Dr Paul Hofman, who led the study, said: "Given that large birth size is associated with increased risk of obesity, a modest reduction in birth weight may have long-term health benefits for offspring by lowering this risk later in life."

Dr Anne Dornhorst, who specialises in research into the metabolism of pregnant women, said that it was becoming clear that exercise during pregnancy could aid the health of mother and child.

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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A timeline of some of the key changes to mother and baby during pregnancy.

WEEKS 10-19WEEKS 20-29WEEKS 30-birth

WEEKS 1-9

In the UK pregnancy is calculated from the first day of the woman’s last period so for as much as three weeks of this first month she might not be actually pregnant.

The fertilized egg begins as a single cell which quickly multiplies to form an embryo as it travels towards the womb. The embryo attaches itself to the womb lining, which is already thickening to support it. For many women the first sign of pregnancy is a missed period in week five.

Shop-bought tests are considered largely reliable so the mother-to-be does not have to have her pregnancy confirmed by her GP. If a first test is negative a second one a few days later may prove positive as hormone levels in the urine rise.

The embryo is now about the size of a baked bean and its spine and nervous system begin to form.

It already has its own blood system and may be a different blood group from its mother. Blood vessels are forming in what will become the umbilical cord and tiny buds which will become limbs

The baby´s heart is beginning to develop by week seven. Around this time many women find they experience the side-effects of early pregnancy including needing to urinate more often nausea and vomiting and feeling a bit weepy and irritable.

All medication including supplements need to be carefully checked as the baby is undergoing vital development in the first 12 weeks. If the woman has not told her GP or community midwife she is pregnant yet, now is a good time to do so.

It is quite common to have a first scan at week eight if the woman has had a previous miscarriage or bleeding. At about this time the embryo officially becomes a foetus.

An early scan is often done through the vagina and is used to check the pregnancy is not ectopic. It should show up the baby´s heartbeat. The nervous system is also developing rapidly especially the brain. The head gets bigger and eyes form under the skin of the face. The foetus’ limbs are growing and look more like arms and legs. All internal organs are developing and becoming more complex.

Women who may be at higher risk of passing on sickle cell anaemia and thalassaemia should be offered a blood test before 10 weeks.

These conditions are rare but serious inherited blood disorders. They are more common in people of certain ethnic backgrounds including African, Caribbean and some Asian and Mediterranean communities. If the mother is found to carry the gene for either condition, the father is offered a test. If both parents are found to be carriers then they are offered the option of testing the foetus in the womb.

WEEK 10-19

A scan at 10-13 weeks is recommended to estimate when the baby is due and to check whether there is more than one baby. This scan may also be part of a screening test for Down’s syndrome.

Testing for Down’s Syndrome can take place between now and 13 weeks. The nuchal translucency scan is used to measure the amount of fluid under the skin at the back of the baby’s neck. If it is increased this raises the risk of Down’s syndrome. A blood test is taken at the same time which measures two hormones in the blood. The combined results of both tests will be used to give the mother a statistical guide to her chances of having a baby with Down’s Syndrome.

The umbilical cord is fully formed providing nourishment and removing waste products. The foetus looks fully human now.

By week 12 the threat of miscarriage is much reduced. By now the foetus is fully formed and many women announce their pregnancy to friends and colleagues.

The foetus is growing in length much more quickly, by now it is about eight cm long and weighs about 60 grams. The placenta is also well formed though it’s not yet doing its full job it takes over fully in week 14. The mother is likely to have her first scan this week.

The woman’s uterus is becoming larger and is starting to rise out of the pelvis and the pregnancy is probably beginning to show. The foetus can move its head quite easily although the mother may not feel any movement yet.

Week 14 is one third of the way through. The average pregnancy lasts 266 days or 280 days from the first day of last period.

If screening for Downs syndrome wasn’t carried out earlier, it is offered about week 15. A simple blood test is carried out first then further tests may be offered.

On the basis of the blood test results the woman may opt for a Chorionic Villus sample or an amniocentesis which would diagnose Down’s syndrome or other chromosomal abnormalities. However these diagnostic tests have a small risk of subsequent miscarriage. An alternative to blood tests is a nuchal translucency scan a new scan offered by some larger hospitals. But again an amniocentisis would be required for firm diagnosis.

The foetus has toe and finger nails eyebrows and eyelashes by week 16. It is also covered with very fine, downy hair, called lanugo. This hair probably serves as some form of insulation and protection for the skin and it disappears before birth or shortly after.

Most women who’ve been suffering from morning sickness are usually feeling better by now.

In week 17 the foetus can hear noises from the outside world. By this stage the mother is visibly pregnant and the uterus is rising.

Ultrasound scan or anomaly scan to check the physical development of the baby, is made during weeks 18-20. The scan can show the foetus in fine detail and often reveal if the baby is a boy or a girl. However not all hospitals offer to tell parents the sex of the child – and not all parents want to know.

By this stage the foetus is moving around a lot – probably enough to be felt.

At week 19 the foetus is now about 15-20cm long and weighs about 300g. Milk teeth have formed in the gums.

WEEKS 20-29

Half way through pregnancy now. Some women experience a surge of energy. The foetus develops a waxy coating called vernix, which is probably provides protection for the skin as the baby floats in amniotic fluid.

The mother’s uterus begins to push against her diaphragm leaving less space for the lungs. Feeling slightly short of breath can be normal at this stage, but the mother should seek medical advice if she experiences these symptoms.

The foetus’s senses begin to develop at about week 22: taste buds have started to form on the tongue and the foetus starts to feel touch.

The skeleton continues to develop and bones that form the skull begin to harden – but not fully.

In week 24, an antenatal checkup and scan will check the baby´s position. A baby born this early can now survive with medical help, although it may be prone to breathing difficulties as its lungs would not be strong enough to cope. It would also be very thin lightweight and susceptible to infections.

At week 25 all organs are now in place and the rest of the pregnancy is for growth. Preeclampsia is a risk from here onwards.

This potentially fatal condition causes high blood pressure protein in the urine and swelling caused by fluid retention. The causes are unclear but research suggests it may be linked to an immune reaction to the foetus or the placenta. If the condition is serious women may be advised to take drugs to lower their blood pressure and in some cases an early caesarean or induction may be performed. Serious complications of pregnancy

The foetus skin is gradually becoming more opaque than transparent.

The foetus measures about 34cm and weighs about 800g by week 27.

In week 28 a routine checkup will test for preeclampsia. Women with Rhesus negative blood will also be tested for antibodies.

If the mother has Rh negative blood but the baby is Rh positive she can develop antibodies to her baby´s blood during labour. This is not a problem in the first birth but can affect subsequent pregnancies and result in stillbirth. Fortunately treatment is simple and effective. BBC Health: Ask the doctor – Rhesus disease

In week 29, some women develop restless leg syndrome in their third trimester.

This is sensations such as crawling tingling or even cramps and burning inside the foot or leg – often in the evening and at night disturbing sleep and making the mother feel she needs to get up and walk around. No-one knows what causes this harmless but irritating condition.

WEEKS 30-BIRTH

Braxton Hicks contractions may begin around now. They are practice contractions which don’t usually hurt.

These are irregular, painless contractions which feel like a squeezing sensation near the top of the uterus. If contractions become painful or occur four times an hour or more, the woman should call a doctor as she may be in early labour.

By week 31 the foetus can see now and tell light from dark. The mother’s breasts start to produce colostrum about now

This high calorie milk is produced by the mother to feed the baby for the first few days after birth before normal milk starts.

Week 32 – another antenatal appointment. The foetus is about 42cm and weighs 2.2kg. A baby born now has a good chance of survival.

From week 33 the baby should become settled in a head downwards position. A midwife can help to move it if necessary.

The mother may find it more difficult to eat full meals as the expanded uterus presses on her stomach.

If the mother has been told she may need a planned caesarean, week 35 is probably a good time to discuss it further.

From about week 36 the baby´s head may engage in the pelvis any time now.

Any baby born after week 37 is considered to be full term.

The baby´s lungs are practically mature now and it can survive unaided. The final weeks in the womb are to put on weight.

Another ante-natal appointment. By week 39 the mother has reached her full size and weight by now.

In theory the baby should be born in week 40. The mother´s cervix prepares for the birth by softening.

First babies are often up to a week late but if there are signs of distress to mother or child the birth will be induced.

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By Jane Dreaper
BBC News health correspondent

Pregnant women in developing countries face the same risk of death as women in the UK did 100 years ago, according to a coalition of campaign groups.

They are using International Women’s Day to call for more action to reduce deaths among women during pregnancy.

They say improving mothers’ health is "the most off-target" of the UN’s eight Millennium Development Goals.

For every 100,000 live births in developing countries, 450 women die during pregnancy or labour.

The coalition, which includes White Ribbon Alliance, Amnesty International and Oxfam, says that in 1910, 355 women died per 100,000 live births in England and Wales.

In Scotland and Ireland, the rate was higher – at 572 and 531 respectively.

In Ghana today the rate of pregnancy-related deaths is 560, while in Chad it is 1,500. The rate in the UK is now 14 deaths per 100,000.

"There still remains a long way to go for the protection and security of pregnant women and their newborn children"

Brigid McConville, Director of White Ribbon Alliance

The comparison has been drawn because it was 100 years ago that International Women’s Day was established.

The UN says although it is difficult to get accurate figures on maternal mortality, very little progress has been made in sub-Saharan Africa – and deaths in southern Asia "remain unacceptably high".

Brigid McConville, the director of White Ribbon Alliance, which campaigns for safe motherhood, said: "There still remains a long way to go for the protection and security of pregnant women and their newborn children."

Monday is the official launch of a week of events. Campaigners will march at the Millennium Bridge in London and lay white roses outside Parliament.

Preventable deaths

Some countries have made progress in improving women’s health – most notably Nepal and Rwanda.

In Mongolia, reduced deaths were achieved by educating women about the signs of complications in pregnancy and by helping them travel to special homes where they could wait to give birth.

Many of the medical problems are easily preventable if, for example, women have access to skilled health workers who can treat infections and use drugs to prevent haemorrhage.

The Millennium Development Goal also envisages preventing deaths that result from complications after unsafe abortions and allowing women access to contraception – to prevent riskier births in teenage mothers and to allow them to space their children.

The issue has become politically more significant in recent years, with the backing of the British Prime Minister’s wife Sarah Brown, who is patron of the White Ribbon Alliance.

The Women Deliver conference in Washington DC in June aims to put increased pressure on world leaders to tackle the problems.

Amnesty International’s UK director Kate Allen said: "It’s clearly been possible to cut back on the rate of maternal deaths here in the UK.

"We need to demonstrate that same level of commitment worldwide."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Schools Secretary Ed Balls has defended the government’s record on teenage pregnancies, as new data is likely to show a key target will be missed.

Mr Balls said he expected statistics to show that the rate of teenage pregnancies is now the lowest it has been for well over a decade.

But he conceded it would be "really hard" to achieve the pledged target of a 50% decline on 1998 figures by 2010.

The statistics will be published by the Office of National Statistics.

Speaking on BBC Breakfast, the Schools Secretary also defended legislation passed on Tuesday night that will force faith schools to teach sex education.

An amendment to the Children, Schools and Families Bill will mean that religious educators will be allowed to teach personal, social, health and economic (PSHE) lessons "in a way that reflects the school’s religious character".

The amendment was passed by a majority of 345 in the Commons.

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Pregnant women do not need to "eat for two", drink full fat milk or even alter how much food they eat for the first six months, NHS experts say.

In the last three months they only need an extra 200 calories a day, draft advice from the National Institute for Health and Clinical Excellence says.

It also urges women to have a "realistic expectation" of how long it will take to lose weight after birth.

The myth-busting guidance is now out for consultation.

Women trying to get pregnant who are obese – body mass index over 30 – should be advised about the increased risk to themselves and their babies, the guidelines, which are aimed at GPs, health visitors, midwives, and other health professionals, state.

"In today’s society women are bombarded by often conflicting advice on what constitutes a healthy diet and how much physical activity they should do during pregnancy and after birth"

Professor Mike Kelly, NICE

Encouragement and advice on losing weight before pregnancy should be offered for this group, it says.

Pregnant women, especially those who are overweight or obese, should be encouraged to eat a healthy diet and do exercise.

But weight loss during pregnancy should not be advocated.

Women need to be aware that a moderate amount of exercise will not harm their baby and women who did exercise, such as running or aerobics, before pregnancy should be able to continue with no adverse effects.

Post pregnancy

The guidelines, which are out for consultation until 18 March, also cover losing weight after giving birth.

Women should be sensitively encouraged to lose excess weight but be warned that sensible gradual weight loss will take time – in contrast to some high profile celebrities who seem to reach pre-baby weight within weeks of childbirth.

The recommendations also point out that eating healthily and taking regular exercise will not affect the quality or quantity of breast milk.

Professor Mike Kelly, director of the centre for public health excellence at NICE, said: "In today’s society women are bombarded by often conflicting advice on what constitutes a healthy diet and how much physical activity they should do during pregnancy and after birth.

"Many overweight women have healthy babies, but the evidence does suggest that there are more risks associated with pregnancies in women who have a BMI of over 30.

"We want all women to be supported before, during and after they have children so that both they and their babies have the healthiest outcome possible."

He said the guidelines give very practical advice and aim to dispel myths.

He added that advice on healthy eating and physical activity for women after they have had a baby should take into account the demands of looking after a small baby and how tired the women are and any health problems they may have.

Jane Munro, from the Royal College of Midwives, welcomed the guidance and said weight was often an issue of concern for most women.

"It will be particularly helpful in dispelling post-pregnancy myths.

"Women need to understand that losing weight after giving birth can be a slow process and that physical exercise and gradual weight loss will not impact on their ability to breastfeed."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Experts fear older women are ditching contraception in the mistaken belief that they cannot get pregnant past a certain age.

The Family Planning Association (FPA) believes the message on infertility and age has gone "too far".

Although fertility does wane, women can still fall pregnant well into their thirties, forties and even fifties.

Abortion rates for women aged 40 to 44 match those for the under 16s, figures for England and Wales show.

In 2008, both of these groups had an abortion rate of four per 1,000 women.

"Whilst the message about fertility declining with age is an important one, it is often overplayed"

FPA Chief Executive Julie Bentley

There are many reasons why some women opt for an abortion – including birth abnormalities in the baby, which are more common when the mothers are older.

But FPA says its anecdotal evidence suggests some of the abortions are because women wrongly assumed they could not get pregnant because they were too old.

Aimed at women aged 35 and over, the FPA’s new campaign ‘Conceivable’ reminds women to stay vigilant about unplanned pregnancy and to keep using contraception until after the menopause if they do not wish to become pregnant.

Chief executive of the FPA Julie Bentley said: "Whilst the message about fertility declining with age is an important one, it is often overplayed, alongside disproportionate messaging about unplanned teenage pregnancies.

"It sends an inaccurate message to women and society that only the young fall pregnant and is leading older women to believe their fertility has gone long before it actually has."

Once is enough

She said women should realise it is entirely conceivable that just one night of unprotected sex in your late 30s, 40s and even 50s can end in an unplanned pregnancy.

"Our helpline receives calls from such women, shocked this has happened to them.

"They thought their age would protect them from becoming pregnant."

She said in general all methods of contraception were suitable for the over-35s.

Women aged 30 to 34 continue to have the highest fertility rate – 113.1 live births per 1,000 women.

But the rate among women aged 40 and over has more than doubled since 1988, from 5.1 to 12.6 per 1,000 women, and there were more than 26,000 live births to women in this age group in 2008, figures from the Office for National Statistics show.

Emily James of Marie Stopes International said: "Many older women facing an unplanned pregnancy are completely shocked to find themselves in this position – many assume that their irregular periods are due to menopause, and are surprised to learn that they are in fact pregnant.

"It is vital that women of all ages are provided with the information, support and advice they need when deciding whether or not to continue with an unplanned pregnancy."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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Expectant mums need to stop blaming their bump for memory lapses, say experts who want to dispel the "baby brain" myth.

Neither pregnancy nor motherhood addle a woman’s brain, say the researchers based on their study of 1,241 women both before and after having babies.

The Australian researchers say we have been misled by a fallacy.

Any absentmindedness might be adaptive, shifting attention to the baby, the British Journal of Psychiatry says.

Lead researcher Professor Christensen said: "Part of the problem is that pregnancy manuals tell women they are likely to experience memory and concentration problems – so women and their partners are primed to attribute any memory lapse to the ‘hard to miss’ physical sign of pregnancy.

"It is about time that some research lays to rest this notion of pregnant women and the ‘baby brain’ myth"

Cathy Warwick of the Royal College of Midwives

"Pregnant women may also shift their focus away from work issues to help them prepare for the birth of their new baby, while new mothers selectively attend to their baby."

But she said this shift should not be labelled a "cognitive deficit".

Fallacy

Her team from The Australian National University followed up the large group of women at four-year intervals using memory tests.

During the course of the study more than half of the women fell pregnant, but this did not appear to have any impact on memory.

The test scores remained unchanged before and after pregnancy and did not differ greatly between the group of women who became mums and the group of those who did not.

Professor Christensen and her team said: "Not so long ago, pregnancy was ‘confinement’ and motherhood meant the end of career aspirations.

"Our results challenge the view that mothers are anything other than the intellectual peers of their contemporaries.

"Women and their partners need to be less automatic in their willingness to attribute common memory lapses to a growing or new baby.

"And obstetricians, family doctors and midwives may need to use the findings from this study to promote the fact that ‘placenta brain’ is not inevitable."

Cathy Warwick of the Royal College of Midwives said: "It is about time that some research lays to rest this notion of pregnant women and the ‘baby brain’ myth.

"The physical and emotional stresses on a woman’s body from pregnancy can make women feel more tired than usual.

"As we all know tiredness – for men as well as women – can make us lose concentration and cause us to function less effectively.

"This is why midwives encourage pregnant women to take appropriate rest breaks, at home and at work. Many pregnant women will need this rest, and all of them deserve it."

This article is from the BBC News website. © British Broadcasting Corporation, The BBC is not responsible for the content of external internet sites.

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