Pregnancy risks determined from birth certificate data - United States, 1989

Article Abstract:

The revised birth certificate used in the US since 1989 allows scientists to track certain characteristics of pregnant women that are associated with poor outcomes. Data from 3.9 million birth certificates recorded in 1989 show that 17% of white women and 27% of black women do not gain the recommended weight during pregnancy. Inadequate weight gain was also associated with low-birth-weight infants. Low-birth-weight infants have an increased risk of mortality and subsequent childhood diseases. Women who smoked during pregnancy were also more likely to deliver low-birth-weight infants. Smoking is also associated with miscarriages, intrauterine growth retardation and premature birth. Women with less than a high school education are those most likely to smoke. Twenty-three percent of all deliveries in 1989 were by Cesarean section. Less than 20% of women who had a Cesarean for a previous pregnancy delivered subsequent infants vaginally.

Health aspects, Smokers, Weight gain

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Management of gestational diabetes mellitus: a self-fulfilling prophecy?

Article Abstract:

The treatment of gestational diabetes mellitus may help prevent macrosomia, however such treatment may not reduce the rate of cesarean deliveries because of physician bias. Gestational diabetes is characterized by elevated levels of glucose in the blood of pregnant women and often leads to macrosomia, excessively large size of newborns. A 1996 study showed that treatment of gestational diabetes often prevented macrosomia but did not reduce the likelihood of cesarean birth. This lack of affect on cesarean delivery may be caused by doctors' fears that gestational diabetes causes babies shoulders to become trapped in the birth canal. Physicians may also tend to assume that gestational diabetes will result in excessive fetal growth and make cesarean delivery necessary. One reason for the tendency of doctors to resort to cesarean delivery following gestational diabetes is the lack of a precise method for measuring fetal size.

Editorial, Diabetes in pregnancy, Gestational diabetes, Fetal macrosomia

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Cesarean delivery for women presenting with genital herpes lesions: efficacy, risks, and costs

Article Abstract:

A cesarean section should be performed on pregnant women who are having a first episode of genital herpes lesions at the time of delivery but not on those having a recurrent episode. Herpes simplex virus (HSV), the microorganism that causes genital herpes lesions, can be transmitted to the newborn during passage through the birth canal. A study reviewed articles published in the medical literature that examined the use of cesarean section in women with a first episode of lesions and in those with a recurrent episode at the time of delivery. The use of cesarean section in women with recurrent lesions was costly and had a high risk of complications or death for the mother. It was more cost-effective and had fewer risks to the mother if the woman had no prior history of lesions.

Management, Disease transmission, Herpes genitalis, Genital herpes, Childbirth, Delivery (Childbirth)

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