Pregnancy and Birth

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After rising steadily for nearly a decade, the rate of cesarean deliveries appears to have stabilized, according to a new report (www.cdc.gov/nchs/data/databriefs/db124.pdf) from the National Center for Health Statistics. New guidelines and policies encouraging longer gestations have led to a trend of cesarean deliveries occurring more frequently at 39 weeks than at 38 weeks.

While long-acting beta2-agonists (LABAs) and low to moderate doses of inhaled corticosteroids for asthma in pregnancy were not associated with an increased prevalence of adverse perinatal outcomes in a recent cohort study, there was a slight trend toward increased prevalence of low birthweight, premature birth, and small for gestational age infants when mothers were exposed to inhaled corticosteroids at high doses.

Pregnancy after bariatric surgery is associated with a reduced risk of having a large-for-gestational-age infant and an increased risk of having a small-for-gestational-age infant, concluded a matched cohort study of singleton deliveries in Denmark.

Many choose to discontinue antidepressant treatment during attempts to conceive or during pregnancy, in spite of the risks of untreated perinatal depression. Safety profiles of antidepressant use during pregnancy are increasingly being studied, and many women seek alternatives during pregnancy. This article will review several complementary and alternative (CAM) treatments for prenatal unipolar depression: omega-3 fatty acids, folate, St John’s Wort, bright light therapy, massage therapy, and exercise.