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Dr. Patricia Garcia Despite being seven months pregnant with her second child, Rebecca Horrighs, 38, has put on only five pounds. On purpose. That’s because the 240-pound mom is enrolled in Northwestern University’s Healthy for You, Healthy for 2 program, for women who are overweight already or who gained too much during previous pregnancies. Horrighs falls into both categories. With her first child, now three, she packed on 40 pounds, even though she had recently undergone gastric bypass surgery. This time around, she walks 10,000 steps a day and cuts her meal in half if she dines out. (She immediately puts the rest in a to-go box.) “You want to see them grow up,” she says. “It’s good for the baby, too.”
Healthy for You, Healthy for 2 is designed to help the 45 percent of women who enter pregnancy overweight. Those extra pounds can lead to diabetes, high blood pressure, heart disease, and some cancers. And excessive gain during pregnancy appears to increase a baby’s risk of being overweight later. One theory is that fetuses exposed to higher levels of weight-related nutrients (such as glucose) produce more insulin, which promotes weight gain later in life. The new thinking is that doctors need to move more aggressively to prevent pregnant women from eating for two. “Previous studies have shown that minimal intervention is minimally effective,” says Dr. Lisa Neff, the endocrinologist who heads Healthy for You, Healthy for 2. Participants meet with experts in nutrition, exercise, and weight management.
Local doctors are also trying to figure out why more than 10 percent of American women deliver their babies three or more weeks early. This past fall, Northwestern started enrolling 1,200 first-time mothers-to-be in the 18-month, eight-center NuMom2B study, funded by the NIH and designed to predict which moms will deliver early. (To enroll, call 312-926-5952.) Rather than look only at traditional risk factors, such as smoking or weight, researchers are tracking sleep, diet, exercise, and proteins in the blood.
“It has the potential to completely revolutionize what we understand about pregnancy,” says Dr. William Grobman, a study investigator and an ob-gyn at Northwestern’s Feinberg School. “It’s unbelievably exciting what it could do for women’s health and obstetrics care.” The results of the study should personalize medicine, save money, and promote good health: Premature delivery causes half of all cerebral palsy cases and a third of all visual impairments, and it increases the long-term risk of death from heart disease. Researchers should know the results in a fast (for science) three to five years.
Grobman is also enrolling pregnant women in an NIH study that is using 3-D technology to follow fetal growth. With better measurements, doctors will know if an infant stops growing robustly and needs heightened surveillance or an early delivery. (To enroll, call 312-926-8624.) At Feinberg, Dr. Francesca Facco, an ob-gyn, has published research showing that pregnant women who slept fewer than seven hours a night or who reported frequent snoring were more likely to develop gestational diabetes. Now she is looking at whether abnormal sleep affects fetal growth and premature birth.
Access to rapid HIV testing at local hospitals has dramatically reduced the number of newborns infected by the virus. If women with HIV aren’t treated, about one in four will transmit the disease to their infants. Prentice Women’s Hospital at Northwestern hasn’t had a case of HIV transmission from mom to baby since 1996, and rates are also low across the state. The reason: As part of the PRTII (Perinatal Rapid Testing Implementation in Illinois) initiative, doctors at Prentice have helped train every labor-and-delivery unit in the state to do rapid HIV testing when patients in labor don’t know their status. “The notion here is that it’s never too late to intervene,” says Dr. Patricia Garcia, the ob-gyn who codirects the women’s HIV clinic at Northwestern Memorial Hospital.
HEART DISEASE | FERTILITY | PREGNANCY | BREAST AND OVARIAN CANCER
CERVICAL AND ENDOMETRIAL CANCER | OSTEOPOROSIS
HEADACHES, MULTIPLE SCLEROSIS, AND OTHER NEUROLOGIC DISORDERS | DEPRESSION
EATING DISORDERS | INCONTINENCE | IMMUNE DISORDERS | SLEEP DISORDERS
Photograph: Taylor Castle Assistant: Ace Ujimori Hair and Makeup: Morgan Blaul