TERRORISM AND PREGNANCY
Obstetricians and gynecologists are monitoring their patients for any signs of ill effects from the Sept. 11 terrorist attack on America. They are keeping their eye on the rates of miscarriage, preterm delivery, infant mortality and even conception itself. Although most pregnancies will come to term normally, physicians should be on the lookout for any signs of trouble in these troubled times, experts from The American College of Obstetricians and Gynecologists cautioned, noting that prolonged stress from disturbing events may increase the rate of premature, low-birth-weight babies and miscarriages. "Will we see more negative outcomes among pregnant women after Sept. 11 or will birth rates jump following this tragedy? The jury is still out," Dr. Stanley Zinberg, ACOG's vice president for practice activities, said.
EXERCISE AND PREGNANCY
Infant and maternal mortality rates have been steadily declining over the past 30 years, and doctors are re-evaluating just how much pregnant women can do physically without jeopardizing their unborn child. Women seem to already know that they can safely do more than had been thought. The Census Bureau's latest statistics show pregnant women are working longer before the birth and returning sooner to their jobs afterward than their counterparts did three decades ago, said Dr. Raul Artal, professor and chair of the department of ob-gyn and women's health at Saint Louis University School of Medicine. On the exercise front, new ACOG recommendations encourage more activity during pregnancy than ever before: 30 minutes or more of moderate exercise on most, if not all, days of the week. "We've found that the increasing numbers of female athletes and women who enjoy vigorous exercise want to continue that level of fitness during their pregnancy. And in many cases, they can," Artal said. The exceptions: scuba diving, where the fetus is at risk for decompression sickness, and activities with risks for abdominal trauma, such as ice hockey, kickboxing, soccer or horseback riding.
INDUCING LABOR
In the past decade, the number of induced births has doubled, from 8 percent in 1989 to 19.6 percent in 2000, raising concern that the practice has become a matter of convenience, either for the doctor or the patient. Dr. Charles Lockwood, professor and chair of the ob-gyn department at New York University School of Medicine, deems the concerns unwarranted. "Over the past 10 years a number of excellent clinical trials have suggested that various conditions, which were previously treated by observation, are better managed by the induction of labor," he said. These include premature rupture of the membranes at term, which affects 3 percent of deliveries; preeclampsia, 5 percent of deliveries; fetal growth restriction, 3 percent; post-date pregnancies, 4 percent, and a variety of other maternal medical conditions complicating nearly 5 percent of deliveries. "When one adds these bona fide indications for the induction of labor together, they actually exceed the number of inductions performed in the U.S.," Lockwood said.
INFECTIONS AND PREGNANCY
The United States has been successful in reducing the transmission of infectious disease from mother to child, researchers say. Dr. Laura Riley, director of ob-gyn infectious diseases at Massachusetts General Hospital in Boston, said, the country "has achieved great success in reducing or nearly eliminating cases of congenital rubella and syphilis in newborns, as well as the maternal-fetal transmission of HIV." Neonatal Hepatitis B and its long-term effects have been nearly eradicated, she said. "The results can be attributed to public health screening, immunization and treatment efforts, such as the availability of immunoglobulin for Hepatitis B babies," Riley said.
(EDITORS: For more information about PREGNANCY, call 202-484-3321; about EXERCISE, call 202-484-3321; about LABOR, 202-484-3321; about INFECTIONS, call 202-484-3321.)
