Spontaneous and induced abortion among resident physicians

Article Abstract:

It has been reported that female resident physicians are at an increased risk of adverse pregnancy outcomes, such as preterm delivery, retardation of fetal growth, low birth weight, and pregnancy-induced hypertension, especially during the period of residency training. Studies published to date show that first trimester spontaneous abortions (miscarriages) are actually less prevalent in female residents than in the general population, but low response rates to the survey questionnaires limit the reliability of that data. To further investigate the outcome of pregnancy in female residents compared with nonphysicians, a questionnaire was sent to the 5,096 females who graduated from medical school in 1985. To obtain comparison data, the same questionnaire was sent to a random sample of 5,000 (of 12,306 total) male medical school graduates for the same year, to be filled out by their spouse or sexual partner (nonphysician). Data were discarded for those cases where the spouse was also a physician. Approximately 85 percent of the subjects responded from both the male and female physician groups. Female residents reported undergoing spontaneous abortion in 14.8 percent of 1,284 pregnancies; nonphysicians reported this occurrence in 12.6 percent of 1,481 pregnancies. Female residents were much more likely than nonphysicians to voluntarily terminate a pregnancy (8.2 percent versus 2.7 percent). However, this was true only for unmarried women; in the case of married female residents, the rates were roughly equal to those of the nonphysicians. The rate of voluntary pregnancy termination among female residents was about half that of the general United States population between the ages of 25 and 34 years. (Consumer Summary produced by Reliance Medical Information, Inc.)

Residents (Medicine), Abortion, Miscarriage

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Outcomes of pregnancy in a national sample of resident physicians

Article Abstract:

Medical residency is a difficult, strenuous period of training that often demands night work, long shifts and prolonged periods of standing. All of these factors have been associated with an increased risk of preterm delivery (before the 37th week of gestation). Female physicians generally pass through residency training during a period of life when many women wish to have children, and some studies have indicated that pregnant residents suffer an increased rate of adverse outcomes. The present study examines the risks of preterm delivery and other complications of pregnancy in a group of 4,412 medical residents, and a group of 4,235 wives of male residents (a control group). Despite the arduous work of the residents, there were no significant differences in the numbers of miscarriages, ectopic pregnancies (outside of the uterus), and stillbirths between the two groups of pregnant women. A similar number of babies with birth weights less than the 10th percentile for their gestational age were born to mothers in both groups. Although the female residents reported a greater incidence of preterm labor (11 percent) than the control group (6.5 percent), they did not deliver more preterm babies (6.5 percent versus 6.0 percent). Preeclampsia (toxicity of pregnancy) was more frequent among residents (8.8 percent) than controls (3.5 percent). The authors conclude that the effects of long working hours in a very stressful role generally had little effect on the outcome of pregnancy in female medical residents. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Statistics, Job stress, Family, Vocational guidance, Women physicians, Maternity benefits

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Facts and artifacts about anemia and preterm delivery

Article Abstract:

The effect of anemia in the mother on subsequent preterm births was studied in 35,000 pregnancies. There was no significant relationship between anemia and preterm birth except for a slight tendency for women with anemia early in the last trimester of pregnancy to give birth before term. Anemia during the last trimester could not account for the substantially higher rate of preterm birth among black women. Anemia after 30 weeks of pregnancy was not associated with premature birth. In women delivering infants weighing over 2,500 grams, the percentage of red cells in the maternal blood increased by 3 percent among black women and 2 percent among white women from the 25th week of pregnancy to term. Anemia was most likely during the 28th week of pregnancy, and became less likely as delivery approached. Anemia is not a major cause of preterm birth; comparison of women in preterm and term labor produces biased results.

Analysis, Case studies, Anemia, Complications and side effects, Pregnancy, Premature labor, Hematocrit, Anemia in pregnancy

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