The status of circumcision of newborns

Article Abstract:

Circumcision of newborn boys was accepted for many years as a low-risk procedure that would promote hygiene and prevent diseases, such as cancer of the penis and cervical cancer in female partners. But in the late 1960s, the focus began to shift towards concern about pain and psychological trauma, as well as bleeding and infections, from the circumcision procedure. The American Academy of Pediatrics stated its opposition to routine circumcision in 1971, 1975, and 1983, and touched off an anticircumcision movement led by affluent parents with the support of insurance companies who did not want to pay for the procedure. The percentage of male infants who are circumcised has fallen, and is currently around 60 percent nationally; the fewest babies are circumcised on the West Coast (under 50 percent) and the most (70 percent) are circumcised in the Midwest. But just as the anticircumcision movement has gained momentum, the scientific evidence that circumcision does provide health benefits has become increasingly convincing. The author describes the various advantages, which include the following: reduced risk of urinary tract infections, which can be particularly serious in newborns; almost complete prevention of penile cancer, which is virtually unheard of in circumcised men; reduced risk of inflammation (balanitis) and improved hygiene; decreased risk of sexually transmitted diseases such as herpes and syphilis; and indirectly, reduced risk of cervical cancer for the sexual partners of circumcised men. The author concludes that the health advantages of circumcision for newborn boys greatly exceed the minor risks, but issues of cost-effectiveness and priority of the procedure in a financially strained medical care system are more difficult to evaluate. The most recent report by the American Academy of Pediatrics was prepared under the direction of the author, but it makes no recommendations about circumcision; it only summarizes the evidence for and against the procedure. (Consumer Summary produced by Reliance Medical Information, Inc.)

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The question of routine neonatal circumcision

Article Abstract:

The advisability of routine circumcision for newborn boys has become the subject of much controversy. In 1987, 61 percent of newborn male infants were circumcised, which is fewer than in previous years when the practice was accepted as beneficial and virtually free of risk. The author evaluates the evidence for and against circumcision. To put the controversy in perspective, it should be noted that there are few medical procedures that are recommended for all infants or children; these include certain immunizations and injections of vitamin K at birth to prevent a bleeding disorder of newborns. Invasive procedures are only warranted if the advantages are substantial and the risks are small; whether circumcision meets these criteria is the question. The risks of circumcision, primarily infection and bleeding, are very low, while not totally negligible. The real issue is whether the benefits are great enough to justify the procedure. These benefits include a very slight reduction in the risk of penile cancer and the risk of cervical cancer in the female sexual partner, but use of condoms and limiting the number of partners is probably more effective at preventing these cancers, which appear to be caused by the human papillomavirus. The risk of infection by HIV, the human immunodeficiency virus, may be somewhat reduced. Urinary tract infections in newborn boys may be prevented by circumcision, but the studies on this subject were apparently flawed and therefore the results are questionable. The author concludes that the risks of circumcision are small, yet the benefits have not been proven, and therefore circumcision should be done only upon the parents' request and not for medical reasons. The decision not to do a circumcision should not be labeled as medical neglect. Parents should be fully informed and allowed to decide; many may base their decision on factors unrelated to health issues. (Consumer Summary produced by Reliance Medical Information, Inc.)

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Second-trimester serum chorionic gonadotropin concentrations and complications and outcome of pregnancy

Article Abstract:

Elevated blood levels of human chorionic gonadotropin do not appear to predict many complications of pregnancy. Human chorionic gonadotropin is a hormone produced during pregnancy. In a study of 28,743 pregnant women, elevated hormone levels were associated with stillbirth, placental abnormalities, hypertension, and premature birth. However, there was no association between elevated hormone levels and gestational diabetes, premature rupture of membranes, or fetal growth retardation. The woman's ethnicity was a more accurate predictor of adverse pregnancy outcome than human chorionic gonadotropin levels.

Diagnosis, Pregnancy, Complications of, Pregnancy complications, Chorionic gonadotropin, Chorionic gonadotropins

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