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Pediatric Academic Societies Report Progress In Children's Health

Vaccines and vaccination, genetics and gene therapy, substance use/abuse and its effects on children, developmental biology, and socioeconomic disadvantage and its effects on children are among the major themes of more than 1,800 abstracts accepted for presentation at the meeting. More than 4,000 people are expected to attend.

Research being reported on Monday, May 4 includes:

• Cocaine babies do not necessarily suffer birth defects In one of the first large, comprehensive studies to refute the long-held belief that cocaine-exposed babies often suffer major birth defects, Dr. Marylou Behnke and colleagues at the University of Florida College of Medicine found no consistent pattern of abnormalities in these children. In fact, more than 75 percent of the babies studied had no major problems, the same as a group of babies who were not exposed to cocaine in utero. Behnke is an associate professor of pediatrics.

• School-based intervention helps reduce obesity in children For the first time, a school-based health behavior intervention program has been shown to reduce obesity in children. The intervention, called Planet Health, was developed by researchers at the Harvard School of Public Health, headed by Dr. Steven Gortmaker, a senior lecturer in the Department of Health and Social Behavior. Planet Health was tested in a two-year, randomized, controlled field trial in 10 Massachusetts public schools. It was effective in girls; for boys, however, there was no difference in the prevalence of obesity in the intervention and control schools. The program reduced television watching by both boys and girls. Other studies have linked television viewing to obesity.

• Doula support lowers cesarean rates, shortens labor For centuries, women have supported women during labor and birth. Drs. John H. Kennell and Susan McGrath of Case Western Reserve University have conducted a series of clinical trials to assess the effects of providing a doula--a female companion experienced in labor and delivery--during uncomplicated births. In their latest study, they examined the impact of a doula in cases of induced labor and found that women who received doula support had reduced cesarean rates and shortened labor. The support of a doula adds to labor and delivery a risk-free, human element that can have a positive medical impact as well, the researchers said.

• Gene therapy successfully administered through bloodstream A breakthrough study on in vivo gene therapy may someday provide the medical know-how to eliminate inherited metabolic disorders. The study was headed by Dr. Mark Batshaw, physician-in-chief at Children's Seashore House, a teaching hospital affiliated with the University of Pennsylvania School of Medicine. Working in mice bred to lack a gene that causes a rare but serious metabolic disorder called Ornithine Transcarbamylase Deficiency (OTCD), the researchers succeeded in injecting normal copies of the OTC gene into the bloodstream, where the new gene served as a blueprint to correct the enzyme deficiency that causes OTCD. Early results were so promising that the FDA has granted the researchers permission to try their gene therapy on adults with partial OTC deficiency, to test its safety before treating severely affected children.

• Very premature babies can survive without severe handicaps A study of babies born 23 to 24 weeks into pregnancy, barely halfway through a normal pregnancy, indicates that even the sickest of extremely premature babies often can survive without serious handicaps. Nine of 10 babies survived, and all nine were evaluated for handicaps at about four years of age. One had no handicaps; six had mild handicaps, and two were severely handicapped, report Dr. Doug Derleth and Dr. William Barbaresi of the Mayo Clinic's Department of Pediatric and Adolescent Medicine. Their findings emphasize how hard it is to predict how extremely premature babies will do when they grow up, the pediatric researchers said.

• Compacted DNA can be delivered through disrupted blood-brain barrier Researchers at Mount Sinai School of Medicine in New York have successfully disrupted the blood-brain barrier in lab rats and generated compacted protein/DNA complexes small enough to pass through the disrupted barrier, enabling them to deliver genes to the brain globally for the first time. Dr. Yiannis A. Ioannou, lead researcher and assistant professor of human genetics, gene therapy and molecular medicine at Mount Sinai School of Medicine, called crossing the blood-brain barrier and achieving global delivery of genes to the brain a major first step in developing gene therapy for diseases of the central nervous system. The next step is to apply the approach to treat laboratory animals with diseases mirroring human disorders, he said.

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