Cotinine-assisted intervention in pregnancy to reduce smoking and low birthweight delivery

Article Abstract:

Smoking during pregnancy increases the risk of low birth weight. The relation between exposure to cigarette smoke and low birth weight depends on the dose, which is measured by number of cigarettes smoked each day or blood levels of cotinine, a by-product of smoking. Studies show that the blood levels of cotinine are more closely related to low birth weight than the reported number of cigarettes smoked each day. Birth weight can be improved if the mother reduces or quits smoking during pregnancy. The feasibility and effect of combining a smoking intervention program with routine prenatal alphafetoprotein screening was assessed. Alphafetoprotein levels are measured before birth to detect defects of the neural tube, which gives rise to the brain and spinal cord. The extent of smoking was determined by measuring the blood levels of cotinine, a product of the breakdown of nicotine, which is contained in cigarettes. The study involved 2,848 pregnant women who smoked 10 or more cigarettes each day and were in the 15th to 20th week of pregnancy. The women received the smoking cessation intervention or the usual antismoking advice. The intervention group were provided with their cotinine measurements and a self-help smoking cessation booklet. Cotinine measurements were made at the start of the study and were repeated one month later; the results were discussed with the mothers in relation to effects on birth weight. The repeat cotinine measurement was intended as a form of feedback to illustrate the impact of reducing smoking on birth weight. The smoking intervention program improved birth weight by 66 grams (about 1.4 pounds) and caused a 30 percent decrease in the rate of low birth weight. These findings show that the combination of a cotinine-assisted smoking intervention program with routine prenatal alphafetoprotein screening is feasible and can reduce the incidence of low birth weight. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Prevention, Birth weight, Low, Low birth weight, Smoking cessation programs, Smoking cessation, Smokers, Prenatal care, Cotinine

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Self-rated physical activity level during the second trimester and pregnancy outcome

Article Abstract:

There is little information on the effects of exercise during pregnancy and pregnancy outcome. Theoretically, exercise could divert blood away from the uterus to the skeletal muscles, possibly having an adverse effect on the fetus. A few recent studies have not found such effects from exercise. To further examine this issue, level of physical activity during the second trimester of pregnancy and pregnancy outcome were examined in a large population. The level of physical activity was self-assessed on a questionnaire. Data on birth weight and fetal and neonatal losses were obtained from the state. A total of 21,342 women participated in the study. Activity level was rated as vigorous by 6 percent of the women, moderate by 84 percent, and light by 10 percent. The women who reported vigorous exercise tended to be older, more educated, and to weigh less. There was no difference in the percentage of women in the three groups who were smokers. Vaginal bleeding was more frequently reported by women who engaged in vigorous activity. There was no significant difference in birth weight among the three groups. The rate of low birth weight was the same for the moderate- and vigorous-activity groups. Percentages of preterm deliveries and fetal and neonatal death were similar for all three groups. The results suggest that vigorous physical activity during the second trimester does not adversely affect the outcome of pregnancy. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Exercise, Exercise physiology, Pregnancy

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Screening for thyroid disorder during pregnancy: Results of a survey in Maine

Article Abstract:

A survey on prenatal screening for thyroid deficiency during pregnancy in Maine was conducted to determine the extent of screening in Maine, factors associated with screening and, laboratory cut-off levels used. The results showed non-significant higher rates for urban versus rural, and multipractitioners versus solo practices.

Health aspects, Diagnosis, Thyroid diseases, Prenatal diagnosis

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