What’s the difference between miscarriage and stillbirth?
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What’s the difference? is a new editorial product that explains the similarities and differences between commonly confused health and medical terms, and why they matter.
Former US First Lady Michelle Obama revealed in her memoir she had a miscarriage. UK singer-songwriter and actor Lily Allen has gone on the record about her stillbirth.
Both miscarriage and stillbirth are sadly familiar terms for pregnancy loss. They can be traumatic life events for the prospective parents and family, and their impacts can be long-lasting. But the terms can be confused.
Here are some similarities and differences between miscarriage and stillbirth, and why they matter.
Let’s start with some definitions
In broad terms, a miscarriage is when a pregnancy ends while the fetus is not yet viable (before it could survive outside the womb).
This is the loss of an “intra-uterine” pregnancy, when an embryo is implanted in the womb to then develop into a fetus. The term miscarriage excludes ectopic pregnancies, where the embryo is implanted outside the womb.
However, stillbirth refers to the end of a pregnancy when the fetus is normally viable. There may have been sufficient time into the pregnancy. Alternatively, the fetus may have grown large enough to be normally expected to survive, but it dies in the womb or during delivery.
The Australian Institute of Health and Welfare defines stillbirth as a fetal death of at least 20 completed weeks of gestation or with a birthweight of at least 400 grams.
Internationally, definitions of stillbirth vary depending on the jurisdiction.
How common are they?
It is difficult to know how common miscarriages are as they can happen when a woman doesn’t know she is pregnant. There may be no obvious symptoms or something that looks like a heavier-than-normal period. So miscarriages are likely to be more common than reported.
Studies from Europe and North America suggest a miscarriage occurs in about one in seven pregnancies (15%). More than one in eight women (13%) will have a miscarriage at some time in her life.
Around 1–2% of women have recurrent miscarriages. In Australia this is when someone has three or more miscarriages with no pregnancy in between.
Australia has one of the lowest rates of stillbirth in the world. The rate has been relatively steady over the past 20 years at 0.7% or around seven per 1,000 pregnancies.
Who’s at risk?
Someone who has already had a miscarriage or stillbirth has an increased risk of that outcome again in a subsequent pregnancy.
Compared with women who have had a live birth, those who have had a stillbirth have double the risk of another. For those who have had recurrent miscarriages, the risk of another miscarriage is four-fold higher.
Some factors have a u-shaped relationship, with the risk of miscarriage and stillbirth lowest in the middle.
For instance, maternal age is a risk factor for both miscarriage and stillbirth, especially if under 20 years old or older than 35. Increasing age of the male is only a risk factor for stillbirth, especially for fathers over 40.
Similarly for maternal bodyweight, women with a body mass index or BMI in the normal range have the lowest risk of miscarriage and stillbirth compared with those in the obese or underweight categories.
Lifestyle factors such as smoking and heavy alcohol drinking while pregnant are also risk factors for both miscarriage and stillbirth.
So it’s important to not only avoid smoking and alcohol while pregnant, but before getting pregnant. This is because early in the pregnancy, women may not know they have conceived and could unwittingly expose the developing fetus.
Why do they happen?
Miscarriage often results from chromosomal problems in the developing fetus. However, genetic conditions or birth defects account for only 7-14% of stillbirths.
Instead, stillbirths often relate directly to pregnancy complications, such as a prolonged pregnancy or problems with the umbilical cord.
Maternal health at the time of pregnancy is another contributing factor in the risk of both miscarriage and stillbirths.
Chronic diseases, such as high blood pressure, diabetes, hypothyroidism (underactive thyroid), polycystic ovary syndrome, problems with the immune system (such as an autoimmune disorder), and some bacterial and viral infections are among factors that can increase the risk of miscarriage.
Similarly mothers with diabetes, high blood pressure, and untreated infections, such as malaria or syphilis, face an increased risk of stillbirth.
In many cases, however, the specific cause of pregnancy loss is not known.
How about the long-term health risks?
Miscarriage and stillbirth can be early indicators of health issues later in life.
For instance, women who have had recurrent miscarriages or recurrent stillbirths are at higher risk of cardiovascular disease (such as heart disease or stroke).
Our research has also looked at the increased risk of stroke. Compared with women who had never miscarried, we found women with a history of three or more miscarriages had a 35% higher risk of non-fatal stroke and 82% higher risk of fatal stroke.
Women who had a stillbirth had a 31% higher risk of a non-fatal stroke, and those who had had two or more stillbirths were at a 26% higher risk of a fatal stroke.
We saw similar patterns in chronic obstructive pulmonary disease or COPD, a progressive lung disease with respiratory symptoms such as breathlessness and coughing.
Our data showed women with a history of recurrent miscarriages or stillbirths were at a 36% or 67% higher risk of COPD, respectively, even after accounting for a history of asthma.
Why is all this important?
Being well-informed about the similarities and differences between these two traumatic life events may help explain what has happened to you or a loved one.
Where risk factors can be modified, such as smoking and obesity, this information can be empowering for individuals who wish to reduce their risk of miscarriage and stillbirth and make lifestyle changes before they become pregnant.
More information and support about miscarriage and stillbirth is available from SANDS and Pink Elephants.
Gita Mishra, Professor of Life Course Epidemiology, Faculty of Medicine, The University of Queensland; Chen Liang, PhD student, reproductive history and non-communicable diseases in women, The University of Queensland, and Jenny Doust, Clinical Professorial Research Fellow, School of Public Health, The University of Queensland
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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An apple cider vinegar drink a day? New study shows it might help weight loss
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Made from fermented apples and naturally high in acetic acid, apple cider vinegar has been popular in recent years for its purported health benefits – from antibacterial properties to antioxidant effects and potential for helping manage blood sugars.
Its origins as a health tonic stretch much further back. Hippocrates used it to treat wounds, fever and skin sores.
An experimental study, released today, looks into whether apple cider vinegar could be effective for weight loss, reduce blood glucose levels and reduce blood lipids (cholesterol and triglycerides).
The results suggest it could reduce all three – but it might not be as simple as downing an apple cider vinegar drink a day.
What did they do?
A group of scientists in Lebanon did a double-blinded, randomised, clinical trial in a group of overweight and obese young people aged from 12–25 years.
Researchers randomly placed 30 participants in one of four groups. The participants were instructed to consume either 5, 10 or 15ml of apple cider vinegar diluted into 250ml of water each morning before they ate anything for 12 weeks. A control group consumed an inactive drink (a placebo) made (from lactic acid added to water) to look and taste the same.
Typically this sort of study provides high quality evidence as it can show cause and effect – that is the intervention (apple cider vinegar in this case) leads to a certain outcome. The study was also double-blinded, which means neither the participants or the scientists involved with collecting the data knew who was in which group.
So, what did they find?
After a period of three months apple cider vinegar consumption was linked with significant falls in body weight and body mass index (BMI). On average, those who drank apple cider vinegar during that period lost 6–8kg in weight and reduced their BMI by 2.7–3 points, depending on the dose. They also showed significant decreases in the waist and hip circumference.
The authors also report significant decreases in levels of blood glucose, triglycerides, and cholesterol in the apple cider groups. This finding echoes previous studies. The placebo group, who were given water with lactic acid, had much smaller decreases in weight and BMI. There were also no significant decreases in blood glucose and blood lipids.
From animal studies, it is thought the acetic acid in apple cider vinegar may affect the expression of genes involved in burning fats for energy. The new study did not explore whether this mechanism was involved in any weight loss.
Is this good news?
While the study appears promising, there are also reasons for caution.
Firstly, study participants were aged from 12 to 25, so we can’t say whether the results could apply to everyone.
The statistical methods used in the study don’t allow us to confidently say the same amount of weight loss would occur again if the study was done again.
And while the researchers kept records of the participants’ diet and exercise during the study, these were not published in the paper. This makes it difficult to determine if diet or exercise may have had an impact. We don’t know whether participants changed the amount they ate or the types of food they ate, or whether they changed their exercise levels.
The study used a placebo which they tried to make identical in appearance and taste to the active treatment. But people may still be able to determine differences. Researchers may ask participants at the end of a study to guess which group they were in to test the integrity of the placebo. Unfortunately this was not done in this study, so we can’t be certain if the participants knew or not.
Finally, the authors do not report whether anyone dropped out of the study. This could be important and influence results if people who did not lose weight quit due to lack of motivation.
Is that you mother? The enzymes in apple cider vinegar might be health-giving.
ShutterstockAny other concerns?
Apple cider vinegar is acidic and there are concerns it may erode tooth enamel. This can be a problem with any acidic beverages, including fizzy drinks, lemon water and orange juice.
To minimise the risk of acid erosion some dentists recommend the following after drinking acidic drinks:
- rinsing out your mouth with tap water afterwards
- chewing sugar-free gum afterwards to stimulate saliva production
- avoiding brushing your teeth immediately after drinking because it might damage the teeth’s softened top layer
- drink with a straw to minimise contact with the teeth.
Rinsing with water could prevent acid damaging your teeth.
ShutterstockDown the hatch?
This study provides us with some evidence of a link between apple cider vinegar and weight loss. But before health professionals can recommend this as a weight loss strategy we need bigger and better conducted studies across a wider age range.
Such research would need to be done alongside a controlled background diet and exercise across all the participants. This would provide more robust evidence that apple cider vinegar could be a useful aid for weight loss.
Still, if you don’t mind the taste of apple cider vinegar then you could try drinking some for weight loss, alongside a healthy balanced and varied dietary intake. This study does not suggest people can eat whatever they like and drink apple cider vinegar as a way to control weight.
Evangeline Mantzioris, Program Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Breadfruit vs Custard Apple – Which is Healthier?
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Our Verdict
When comparing breadfruit to custard apple, we picked the breadfruit.
Why?
Today in “fruits pretending to be less healthy things than they are”, both are great, but one of these fruits just edges out the other in all categories. This is quite simple today:
In terms of macros, being fruits they’re both fairly high in carbs and fiber, however the carbs are close to equal and breadfruit has nearly 2x the fiber.
This also means that breadfruit has the lower glycemic index, but they’re both medium-low GI foods with a low insulin index.
When it comes to vitamins, breadfruit has more of vitamins B1, B3, B5, and C, while custard apple has more of vitamins A, B2, and B6. So, a 4:3 win for breadfruit.
In the category of minerals, breadfruit has more copper, magnesium, phosphorus, potassium, and zinc, while custard apple has more calcium and iron.
In short, enjoy both, but if you’re going just for one, breadfruit is the healthiest.
Want to learn more?
You might like to read:
Which Sugars Are Healthier, And Which Are Just The Same?
Take care!
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Learning to Love Midlife – by Chip Conley
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
While the book is titled about midlife, it could have said: midlife and beyond.
Some of the benefits discussed in this book really only kick in during one’s 50s, 60s, or 70s, usually. Which, for all but the most optimistic, is generally considered to be stretching beyond what is usually called “midlife”.
However! Chip Conley makes the argument for midlife being anywhere from one’s early 30s to mid-70s, depending on what (and how) we’re doing in life.
He talks about (as the subtitle promises) 12 reasons life gets better with age, and those reasons are grouped into 5 categories, thus:
- Physical life
- Emotional life
- Mental life
- Vocational life
- Spiritual life
It may surprise some readers that there are physical benefits that come with aging, but we do get two chapters in that category.
The writing style is very casual, yet with references to science throughout, and a bibliography for such.
Bottom line: if you’d like to make sure you’re making the most of your midlife and beyond, this a book that offers a lot of guidance on doing so!
Click here to check out Learning to Love Midlife, and age in style!
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Red Bell Peppers vs Tomatoes – Which is Healthier?
10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.
Our Verdict
When comparing red bell peppers to tomatoes, we picked the peppers.
Why?
In terms of macronutrients, these two fruits-that-get-used-as-vegetables are similar in most respects; they’re mostly water, negligible protein and fat, similar amounts of carbs, even a similar carb breakdown (mostly fructose and glucose). One thing that does set them apart is that peppers* have about 2x the fiber, which difference results in peppers having the lower Glycemic Index—though tomatoes are quite low in GI too.
*for brevity we’re just going to write “peppers”, but we are still talking about sweet red bell peppers throughout. This is important, as different color peppers have different nutrient profiles.
In the category of vitamins, peppers have much more of vitamins A, B1, B2, B3, B5, B6, B9, C, and E. In contrast, tomatoes have more vitamin K. An easy win for peppers.
When it comes to minerals, the margins are narrower, but peppers have more iron, zinc, and selenium, while tomatoes have more calcium and copper. They’re approximately equal on other minerals they both contain, making this category a slight (3:2) win for peppers.
As for phytochemical benefits, both are good sources of lycopene (both better when cooked) and other carotenes (for example lutein), and both have an array of assorted flavonoids.
All in all, a win for peppers, but both are great!
Want to learn more?
You might like to read:
- Brain Food? The Eyes Have It!
- Bell Peppers: A Spectrum Of Specialties
- Lycopene’s Benefits For The Gut, Heart, Brain, & More
Take care!
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Life After Death? (Your Life; A Loved One’s Death)
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The Show Must Go On
We’ve previously written about the topics of death and dying. It’s not cheery, but it is important to tackle.
Sooner is better than later, in the case of:
Preparations For Managing Your Own Mortality
And for those who are left behind, of course it is hardest of all:
What Grief Does To Your Body (And How To Manage It)
But what about what comes next? For those who are left behind, that is.
Life goes on
In cases when the death is that of a close loved one, the early days after death can seem like a surreal blur. How can the world go ticking on as normal when [loved one] is dead?
But incontrovertibly, it does, so we can only ask again: how?
And, we get to choose that, to a degree. The above-linked article about grief gives a “101” rundown, but it’s (by necessity, for space) a scant preparation for one of the biggest challenges in life that most of us will ever face.
For many people, processing grief involves a kind of “saying goodbye”. For others, it doesn’t, as in the following cases of grieving the loss of one’s child—something no parent should ever have to face, but it happens:
Dr. Ken Druck | The Love That Never Dies
(with warning, the above article is a little heavy)
In short: for those who choose not to “say goodbye” in the case of the death of a loved one, it’s more often not a case of cold neglect, but rather the opposite—a holding on. Not in the “denial” sense of holding on, but rather in the sense of “I am not letting go of this feeling of love, no matter how much it might hurt to hold onto; it’s all I have”.
What about widows, and love after death?
Note: we’ll use the feminine “widow” here as a) it’s the most common and b) most scientific literature focuses on widows, but there is no reason why most of the same things won’t also apply to widowers.
We say “most”, as society does tend to treat widows and widowers differently, having different expectations about a respectful mourning period, one’s comportment during same, and so on.
As an aside: most scientific literature also assumes heterosexuality, which is again statistically reasonable, and for the mostpart the main difference is any extra challenges presented by non-recognition of marriages, and/or homophobic in-laws. But otherwise, grief is grief, and as the saying goes, love is love.
One last specificity before we get into the meat of this: we are generally assuming marriages to be monogamous here. Polyamorous arrangements will likely sidestep most of these issues completely, but again, they’re not the norm.
Firstly, there’s a big difference between remarrying (or similar) after being widowed, and remarrying (or similar) after a divorce, and that largely lies in the difference of how they begin. A divorce is (however stressful it may often be) more often seen as a transition into a new period of freedom, whereas bereavement is almost always felt as a terrible loss.
The science, by the way, shows the stats for this; people are less likely to remarry, and slower to remarry if they do, in instances of bereavement rather than divorce, for example:
Timing of Remarriage Among Divorced and Widowed Parents
Love after death: the options
For widows, then, there seem to be multiple options:
- Hold on to the feelings for one’s deceased partner; never remarry
- Grieve, move on, find new love, relegating the old to history
- Try to balance the two (this is tricky but can be done*)
*Why is balancing the two tricky, and how can it be done?
It’s tricky because ultimately there are three people’s wishes at hand:
- The deceased (“they would want me to be happy” vs “I feel I would be betraying them”—which two feelings can also absolutely come together, by the way)
- Yourself (whether you actually want to get a new partner, or just remain single—this is your 100% your choice either way, and your decision should be made consciously)
- The new love (how comfortable are they with your continued feelings for your late love, really?)
And obviously only two of the above can be polled for opinions, and the latter one might say what they think we want to hear, only to secretly and/or later resent it.
One piece of solid advice for the happily married: talk with your partner now about how you each would feel about the other potentially remarrying in the event of your death. Do they have your pre-emptive blessing to do whatever, do you ask a respectable mourning period first (how long?), would the thought just plain make you jealous? Be honest, and bid your partner be honest too.
One piece of solid advice for everyone: make sure you, and your partner(s), as applicable, have a good emotional safety net, if you can. Close friends or family members that you genuinely completely trust to be there through thick and thin, to hold your/their hand through the emotional wreck that will likely follow.
Because, while depression and social loneliness are expected and looked out for, it’s emotional loneliness that actually hits the hardest, for most people:
Longitudinal Examination of Emotional Functioning in Older Adults After Spousal Bereavement
…which means that having even just one close friend or family member with whom one can be at one’s absolute worst, express emotions without censure, not have to put on the socially expected appearance of emotional stability… Having that one person (ideally more, but having at least one is critical) can make a huge difference.
But what if a person has nobody?
That’s definitely a hard place to be, but here’s a good starting point:
How To Beat Loneliness & Isolation
Take care!
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Kale vs Watercress – Which is Healthier?
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Our Verdict
When comparing kale to watercress, we picked the kale.
Why?
It was very close! If ever we’ve been tempted to call something a tie, this has been the closest so far.
Their macros are close; watercress has a tiny amount more protein and slightly lower carbs, but these numbers are tiny, so it’s not really a factor. Nevertheless, on macros alone we’d call this a slight nominal win for watercress.
In terms of vitamins, they’re even. Watercress has higher vitamin E and choline (sometimes considered a vitamin), as well as being higher in some B vitamins. Kale has higher vitamins A and K, as well as being higher in some other B vitamins.
In the category of minerals, watercress has higher calcium, magnesium, phosphorus, and potassium, while kale has higher copper, iron, manganese, and zinc. The margins are slightly wider for kale’s more plentiful minerals though, so we’ll call this section a marginal win for kale.
When it comes to polyphenols, kale takes and maintains the lead here, with around 2x the quercetin and 27x the kaempferol. Watercress does have some lignans that kale doesn’t, but ultimately, kale’s strong flavonoid content keeps it in the lead.
So of course: enjoy both if both are available! But if we must pick one, it’s kale.
Want to learn more?
You might like to read:
- Fight Inflammation & Protect Your Brain, With Quercetin
- Spinach vs Kale – Which is Healthier?
- Thai-Style Kale Chips (recipe)
Take care!
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