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Findings from an NICHD study indicate that, compared with women at normal weight, women who are obese before pregnancy are much more likely to have babies with problems with the heart’s structure. Congenital heart defects change the normal flow of blood through the heart and can range from simple defects, with no symptoms, to complex defects with severe, life-threatening complications. The new findings suggest that, by losing weight before getting pregnant, women can reduce their babies’ risk for congenital heart defects.

NIH Director Francis Collins, M.D., Ph.D., appoints Alan Guttmacher, M.D., as the new Director of the NICHD. Prior to his appointment as NICHD Acting Director in 2009, Dr. Guttmacher served as the Deputy Director (and before that, Acting Director) of the National Human Genome Research Institute (NHGRI) and served as that Institute’s for more than a year.

Findings from the Fragile Families and Child Well-Being study, launched by the NICHD in 1998, are published in a special issue of the journal, The Future of Children. The study focuses on “fragile families” in which mothers were unmarried when the child was born. Research results show that, when compared to married parents, unmarried couples were more likely to break up, earned less and were more likely to live in poverty, relied more on public and private programs, and were more likely to report poor health and problems with alcohol or drugs. The study also finds that children in these families are at greater risk for abuse, poor performance at school, and behavior problems. These findings have implications for policies that aim to improve outcomes for fragile families.

NICHD researchers identify DNA variants in mothers and fetuses that seem to increase the risk for preterm labor and delivery. The scientists determine that an estimated one of every three preterm infants is born to a mother who has a “silent infection” of the amniotic fluid. They find that individual genetic variation in the immune response and attendant inflammatory hormones may account for why some pregnancies end in early labor and delivery, while others do not. The findings may lead to new strategies to identify those at risk for preterm birth and to reduce the occurrence of preterm birth.

Vaginal Birth After Cesarean conference logoThe NICHD cosponsors a 3-day NIH consensus development conference on vaginal birth after cesarean (VBAC). An independent panel of experts, convened for the conference, conducts an extensive review of the existing research. They conclude that, based on the evidence, a trial of labor is a reasonable option for many pregnant women who have had a previous cesarean delivery.

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Management of Myelomeningocele Study logoResults from an NICHD-funded study show the benefits and risks of prenatal surgery to repair the primary defect in the most severe form of spina bifida, a serious birth defect that affects about three to four of every 10,000 live births in the United States. Spina bifida occurs when the spinal column—including the bones of the spine, muscles, and skin—fails to develop or close completely around the fetal spinal cord while in the womb. Researchers in the Management of Myelomeningocele Study (MOMS) compare outcomes from the standard treatment, surgery to repair the opening in the spinal column after the baby is born, to outcomes from surgery done while the baby is still in the womb. The study shows that, despite a slight increase in risk for preterm delivery, mother and baby have better overall outcomes if the surgery is done before birth.

The NICHD’s National Child and Maternal Health Education Program (NCMHEP) launches a continuing medical education and continuing education course, Raising Awareness: Late Preterm Birth and Non-Medically Indicated Inductions Prior to 39 Weeks. The course alerts health care providers of the impact and effects of late preterm birth and of inducing delivery for nonmedical reasons prior to 39 weeks of pregnancy. It emphasizes that birth at or after 39 weeks allows infants to reach a stage of development that best equips them for life outside of the womb. The course becomes the first in a series of education efforts on this topic undertaken by the NCMHEP.

Constantine A. Stratakis, M.D., D.Sc., is named Scientific Director and Director of the Division of Intramural Research (DIR). Dr. Stratakis served as the Acting Scientific Director of the DIR since June 2009.

The world commemorates the 30th anniversary of the first reported cases of AIDS with several events and symposia. The NICHD highlights key advances within its HIV/AIDS portfolio, which focuses on pediatric, adolescent, and maternal populations. Institute research played a significant role in reducing the rate of mother-to-child transmission of the disease to less than 2 percent in industrialized countries as well as greatly improved survival rates for HIV-infected infants, children, and women worldwide.

An NICHD-led study confirms the benefits of progesterone in reducing the risk of preterm birth for a certain high-risk category of women—those with a short cervix. The study also finds that infants born to these women, even if born before full term, are at reduced risk of dying or having respiratory distress syndrome if progesterone is used. The researchers suggest that screening women for short cervix and the use of progesterone could significantly reduce preterm birth among this population.

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An NICHD-funded study suggests a possible treatment for uterine fibroid tumors, the most common noncancerous tumors in women of childbearing age. Research shows that treatment with vitamin D reduces the size of uterine fibroids in laboratory rats. Additional research is needed to determine whether human fibroid tissue responds the same way and whether the treatment is a viable option for women.

MRI brain imagesThe Infant Brain Imaging Study, funded through the Autism Centers of Excellence (ACE) program—funded by the NICHD, the NIDCD, the NIEHS, the NIMH, and the NINDS—finds that patterns of brain development in the first 2 years of life are distinct in children who are later diagnosed with autism spectrum disorders (ASDs) compared to typically developing children. After tracking children’s brain development at 6 months, 1 year, and 2 years, researchers identify differences in the way certain networks of neural circuits, known as white matter fiber tracts, form connections between the various brain areas. The findings indicate that coherent, organized information pathways develop faster in typically developing children than in those later diagnosed with ASDs.

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