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Effects of marijuana use during pregnancy
tion (PNF) and 117 did receive PNF. PNF was associated with the absence of decayed filled surfaces; 97% were caries free versus 15% of those without PNF (P < 0.001). PNF was associated with heavier birth weights, even when sex adjusted (P < 0.005). PNF twins were longer at birth (P < 0.0001). In addition, PNF was associated with fewer medical and dental birth defects. The virtual elimination of caries in the PNF group is attributed to the dental development in the higher fluoride environment, in which the enamel is formed of calcium fluorapatite, rather than calcium hydroxyapatite. The former is six to ten times more resistant to acid dissolution and has a tighter crystal structure with a smooth surface, free from pits and fissures which allow decay.” PNF teeth have been shown to contain 350-400% more fluoride than teeth produced in pregnancies with fluoridated water alone, and 500-600% more fluoride than teeth produced in pregnancies in communities without fluoridated water. The striking 99% reduction in dental caries with P < 0.0001 cannot be ignored. The authors recommend a separate 1 mg fluoride (2.2 mg sodium fluoride) tablet taken on an empty stomach and not followed by milk, antacids. or calcium-containing supplements.
pregnant and 163 (96%) gave birth to normal infants at term. Mean gestational ages and birthweights were significantly higher than for the group with previous losses.
Magnesium Sulfate Levels in Breast Milk Cruikshank D, Varner M, Pitkin R. Breast milk magnesium and calcium concentrations following magnesium sulfate treatment. Am J Obstet Gynecol 143;685. 1982. This small study evaluated maternal serum and breast milk levels of magnesium and calcium in ten treated women and five control subjects. At the end of the magnesium sulfate infusion, maternal serum magnesium concentrations were significantly elevated and total and ionized calcium levels were depressed. However, by 24 hr later, both serum and milk values had returned to normal. The increased magnesium load that the infant of a treated mother would receive during the first 24 hr after discontinuation of treatment is quite small, only 1.5 mg of magnesium. The calcium content of the colostrum appeared unchanged by the magnesium therapy.
Fluoride Supplementation Glenn F, Glenn W, Duncan R: Fluoride tablet supplementation during pregnancy for caries immunity: A study of the offspring produced. Am J Obstet Gynecol 143:560, 1982.
Electronic Monitor versus Palpation Seitchik J, Rao V: Cesarean delivery in nulliparous women for failed oxytocin-augmented labor: Route of delivery in subsequent pregnancy. Am J Obstet Gynecol 143:393. 1982.
Since it has been confirmed that primary teeth begin their development at 10 to 12 weeks gestation and that permanent molars and incisors begin to develop from the sixth to the ninth months of pregnancy. concern for adequate dental growth has developed. The mineral fluoride has been shown to affect the resistance. morphologic characteristics, and color of developing teeth. This study compares the children of mothers who drank fluoridated water during pregnancy with children whose mothers took a fluoride tablet daily during pregnancy. in addition to drinking fluoridated water. Of the 492 children selected from a private pedodontic practice, 375 had not received prenatal fluoride supplementa-
Journal
of Nurse-Midwifery
l
Vol.
28,
In this report, 58 patients who experienced cesarean section in their first term pregnancy after a failed trial of oxytocin were allowed a trial of labor in their sub-
sequent pregnancy. Cephalopelvic disproportion (CPD) and “failure to progress” were the sole indications for the first cesareans. Forty of the 58 women achieved vaginal delivery. In attempting to discover one factor which would predict these successful vaginal deliveries, the authors found the only statistically significant pa-
No.
In their discussion the authors question the diagnoses of uncompliant cervix, and relative CPD since so many patients delivered second similarly sized infants after spontaneous labor. They also question whether the use of the electronic monitor to evaluate adequacy of uterine contractions has contributed to these possibly unnecessary cesareans in the past. “Did these patients whose first labors were not progressive require more uterine activity than the average woman achieves in normal labor? Is it possible that the clinician who used palpation achieved greater uterine activity with oxytocin than we do now?”
Effects of Marijuana Use during Pregnancy Greenland S, Staisch K. Brown N, et al.: The effects of marijuana use during pregnancy. I. A preliminary epidemiologic study. Am J Obstet Gynecol 143:408, 1982. This prospective study of the effects of marijuana use in 35 pregnancies found few adverse outcomes, but the infants born to marijuana users (average use once per week) exhibited significantly more meconium staining (57% versus 25% in nonusers). Users and the matched nonuser controls were similar with respect to most potentially confounding prenatal risk factors, although users tended to come from lower income and educational backgrounds. An additional finding was that a higher proportion of users experienced prolonged, protracted. or arrested labor (nonsignificant) and precipitate labor (29% versus 3%. P < 0.01).
SGA Infant Follow-up Winer E, Tejani N, Atluru V. et al.: Four- to seven-year evaluation in two groups of small-for-gestational age infants. Am J Obstet Gynecol 143: 425, 1982.
rameter was second pregnancy birth-
In this study 55 small-for-gestational age (SGA) infants were tested for intellectual and neurologic development at 4-7 years of age. The infants’ development was compared according to whether or not the mother had hypertensive disease. The children of the hypertensive women scored better in all of the intel-
weight less than 3500 g.
lectual testing (significant only for verbal
1, January/February
1983
31
pregnant and 163 (96%) gave birth to normal infants at term. Mean gestational ages and birthweights were significantly higher than for the group with previous losses.
Magnesium Sulfate Levels in Breast Milk Cruikshank D, Varner M, Pitkin R. Breast milk magnesium and calcium concentrations following magnesium sulfate treatment. Am J Obstet Gynecol 143;685. 1982. This small study evaluated maternal serum and breast milk levels of magnesium and calcium in ten treated women and five control subjects. At the end of the magnesium sulfate infusion, maternal serum magnesium concentrations were significantly elevated and total and ionized calcium levels were depressed. However, by 24 hr later, both serum and milk values had returned to normal. The increased magnesium load that the infant of a treated mother would receive during the first 24 hr after discontinuation of treatment is quite small, only 1.5 mg of magnesium. The calcium content of the colostrum appeared unchanged by the magnesium therapy.
Fluoride Supplementation Glenn F, Glenn W, Duncan R: Fluoride tablet supplementation during pregnancy for caries immunity: A study of the offspring produced. Am J Obstet Gynecol 143:560, 1982.
Electronic Monitor versus Palpation Seitchik J, Rao V: Cesarean delivery in nulliparous women for failed oxytocin-augmented labor: Route of delivery in subsequent pregnancy. Am J Obstet Gynecol 143:393. 1982.
Since it has been confirmed that primary teeth begin their development at 10 to 12 weeks gestation and that permanent molars and incisors begin to develop from the sixth to the ninth months of pregnancy. concern for adequate dental growth has developed. The mineral fluoride has been shown to affect the resistance. morphologic characteristics, and color of developing teeth. This study compares the children of mothers who drank fluoridated water during pregnancy with children whose mothers took a fluoride tablet daily during pregnancy. in addition to drinking fluoridated water. Of the 492 children selected from a private pedodontic practice, 375 had not received prenatal fluoride supplementa-
Journal
of Nurse-Midwifery
l
Vol.
28,
In this report, 58 patients who experienced cesarean section in their first term pregnancy after a failed trial of oxytocin were allowed a trial of labor in their sub-
sequent pregnancy. Cephalopelvic disproportion (CPD) and “failure to progress” were the sole indications for the first cesareans. Forty of the 58 women achieved vaginal delivery. In attempting to discover one factor which would predict these successful vaginal deliveries, the authors found the only statistically significant pa-
No.
In their discussion the authors question the diagnoses of uncompliant cervix, and relative CPD since so many patients delivered second similarly sized infants after spontaneous labor. They also question whether the use of the electronic monitor to evaluate adequacy of uterine contractions has contributed to these possibly unnecessary cesareans in the past. “Did these patients whose first labors were not progressive require more uterine activity than the average woman achieves in normal labor? Is it possible that the clinician who used palpation achieved greater uterine activity with oxytocin than we do now?”
Effects of Marijuana Use during Pregnancy Greenland S, Staisch K. Brown N, et al.: The effects of marijuana use during pregnancy. I. A preliminary epidemiologic study. Am J Obstet Gynecol 143:408, 1982. This prospective study of the effects of marijuana use in 35 pregnancies found few adverse outcomes, but the infants born to marijuana users (average use once per week) exhibited significantly more meconium staining (57% versus 25% in nonusers). Users and the matched nonuser controls were similar with respect to most potentially confounding prenatal risk factors, although users tended to come from lower income and educational backgrounds. An additional finding was that a higher proportion of users experienced prolonged, protracted. or arrested labor (nonsignificant) and precipitate labor (29% versus 3%. P < 0.01).
SGA Infant Follow-up Winer E, Tejani N, Atluru V. et al.: Four- to seven-year evaluation in two groups of small-for-gestational age infants. Am J Obstet Gynecol 143: 425, 1982.
rameter was second pregnancy birth-
In this study 55 small-for-gestational age (SGA) infants were tested for intellectual and neurologic development at 4-7 years of age. The infants’ development was compared according to whether or not the mother had hypertensive disease. The children of the hypertensive women scored better in all of the intel-
weight less than 3500 g.
lectual testing (significant only for verbal
1, January/February
1983
31