Pregnancy and Birth

Low-level lead exposure, measured by umbilical blood lead levels, suggests a significant association with elevations in maternal blood pressure during labor and delivery, according to a study published online Feb. 3 in Environmental Health Perspectives.

The incidence and severity of cerebral palsy (CP) among preterm survivors decreased significantly from 1990 to 1993 onward, possibly because of a reduction in severe cystic periventricular leukomalacia (c-PVL), according to a study published online March 3 in The Journal of Pediatrics.

A recent article in the Wall Street Journal describes some of the ways health care professionals are collaborating to improve obstetrics care, thanks in part to grants from the federal Agency for Healthcare Research and Quality.

The 2009 H1N1 pandemic caused anxiety and concern, especially for pregnant women and their physicians. The Centers for Disease Control (CDC) recognized this special patient population and the increased risk for serious problems and negative outcomes-both for the women and their unborn babies. As such, the CDC advised doctors to provide antiviral medicines to those with symptoms of the flu and vaccines to those pregnant women who were eligible. They further partnered with the American College of Obstetricians and Gynecology, the American Medical Association, and the American Academy of Family Physicians to educate clinicians and urge their participation in the 2009 H1N1 vaccination programs.

Maternal use of opioid analgesics just prior to or during early pregnancy is associated with a modestly higher risk of certain birth defects, according to a study published online Feb. 24 in the American Journal of Obstetrics & Gynecology.

Postmenopausal women who used to smoke or who currently smoke appear to be at a higher risk of invasive breast cancer than postmenopausal women who never smoked, according to a study published online March 1 in BMJ.

The U.S. Food and Drug Administration has notified health care providers and consumers that new data indicate that women who take topiramate (Topamax) during pregnancy increase the risk for cleft lip and cleft palate in their offspring.

Women who smoke cigarettes during the first trimester of pregnancy may increase their offspring's risk for congenital heart defects (CHDs), according to research published online Feb. 28 in Pediatrics.

When used properly, oral contraceptives are extremely effective in preventing unintended pregnancies, yielding only 3 pregnancies per 1000 users in the first year of use. In reality, however, women may not be as adherent as necessary to obtain this ideal rate-studies have shown that about 50% of women regularly miss at least 1 pill per cycle.

News of KV Pharmaceutical’s plan to sell Makena (hydroxyprogesterone caproate injection) at up to $1500 per injection is receiving some serious backlash. The drug-perhaps best known to physicians as 17P-has been used for years to prevent preterm deliveries. Before Makena’s FDA approval last month, 17P had an “orphan drug” designation; forms of the medication were custom-compounded in pharmacies, which were then provided to patients at a cost of around $10.

Makena (hydroxyprogesterone caproate) has been approved by the U.S. Food and Drug Administration to help prevent birth before 37 weeks of pregnancy in women who have had at least one prior early delivery.

The American Heart Association (AHA) has compiled a series of evidence-based recommendations for the diagnosis, management, and treatment of cerebral venous thrombosis (CVT), and specifically for its management during pregnancy and postpartum, detailed in a statement published online Feb. 3 in Stroke.

The U.S. teenage birth rate has resumed its decline, reaching a historic low in 2009, according to a report published in the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS) February Data Brief.

Sex during pregnancy is generally safe, and abstinence should be recommended only for women at risk of preterm labor or antepartum hemorrhage due to placenta previa, according to a primer published online Jan. 31 in CMAJ, the journal of the Canadian Medical Association.

Overnight closed-loop insulin delivery appears to be safe among pregnant women, according to a study published in the February issue of Diabetes Care.

Is there a way to predict which patients will have the best outcomes following an assisted reproductive intervention? Dr William Gibbons, director of the Family Fertility Program at Texas Children’s Hospital and professor of obstetrics and gynecology at Baylor College of Medicine, and colleagues examined birth weight and gestational age of singleton pregnancies from in vitro fertilization, donor egg, and gestational carrier cycles to determine which factors most influence outcomes.

Progesterone support during the luteal phase is needed to allow for implementation in medically assisted cycles. To date, available options have not met all of the ideals of the “perfect” progesterone strategy-easy to administer, safe with minimal adverse effects, and effective in producing pregnancies.

The fertility field has seen incredible successes with in vitro fertilization and intracytoplasmic sperm injection. However, the resulting successes have yielded concern over the high rates of multiple pregnancies, which can result in increased maternal and perinatal morbidity and mortality as well as increased health care utilization and costs.

One serum blood test is sufficient to diagnose hyperprolactinemia, and dynamic testing of prolactin secretion should be avoided, according to new guidelines published in the February issue of the Journal of Clinical Endocrinology & Metabolism.

Injectable terbutaline should not be used for prevention or prolonged treatment of preterm labor in pregnant women because of the potential for serious maternal heart problems and death, according to a warning issued by the U.S. Food and Drug Administration. The agency also warned that oral terbutaline should not be used for prevention or any treatment of preterm labor because of similar safety concerns and the fact that it has not been shown to be effective.

Evidence shows that combined oral contraceptives are contraindicative in women who have migraines with auras (MA) due to increased risk of ischemic stroke. So what can these women do?

Despite the wide range of contraceptives available, almost 50% of pregnancies in the United States are unintended, with the highest rates among women aged 18 to 24 years. Meanwhile, few studies have explored contraceptive responsibility and no studies since the 1980s have looked at female college students’ perceptions of such. Without this data, physicians and health educators are unable to adequately and effectively address STD and pregnancy prevention among this patient population.

Adequate breast-feeding of a baby exposed to diabetes in utero may protect against childhood adiposity, according to a study published in the March issue of Diabetes Care.

Emotional distress some women experience prior to undergoing fertility treatment appears to have no bearing on the likeihood that the treatment will result in a successful pregnancy, according to a literature analysis published Feb. 23 in BMJ.

Patients with type 2 diabetes who are treated with bupropion (BU) for major depressive disorder (MDD) show significant improvement in sexual function, according to a study published in the February issue of Diabetes Care.

Although mothers with type 1 diabetes are less likely to partially or exclusively breast-feed at two months, diabetes is not an independent risk factor for the initiation and maintenance of breast-feeding, according to a study published in the February issue of Diabetes Care.

The U.S. Food and Drug Administration has notified health care providers that the Pregnancy section of drug labels include additional and consistent information regarding the potential risk for abnormal muscle movements (extrapyramidal signs [EPS]) and withdrawal symptoms among newborns whose mothers received the drugs in the third trimster of pregnancy.

Interpreting a high volume of mammograms ma not lead radiologists to find more cancers but my help them to better distinguish between malignant and non-malignant lesions, according to research published online Feb. 22 in Radiology.

Women who are extremelly obese may not need to gain as much weight during the second and third trimesters of pregnancy as current guidelnes recommend, according to research presented at the Society for Maternal-Fetal Medicine's annual meeting, The Pregnancy Meeting, held from Feb. 7 to 12 in San Francisco.

In utero and early infancy exposure to diagnostic X-rays may increase the risk for childhood cancers, according to research published online Feb. 10 in BMJ.