Sunday, April 8, 2012

Why induce?


I spent today with some lovely moms and moms-to-be, and read a lot of posts on Facebook, so this seems timely. Some of the women commented how they'd like to be induced early, instead of carrying their next pregnancy to the full 40 weeks.

Currently in America, 37 weeks is considered "full-term", but there is mounting evidence that those extra few weeks may be totally worth it (however uncomfortable they may be)!

I've been reading about development lately (in humans and other species), and am really amazed by how much benefit the mother's body can be to facilitating organ and neural development, even in the last few days before birth. As such, it probably shouldn't have been (but still was) a surprise to learn that the second leading cause of mortality in US-born infants is low birth weight and prematurity (http://www.cdc.gov/Features/dsInfantDeaths/).

I have been thinking a lot about how trends in inducing prior to 40 weeks might be affecting humans. In particular, babies born before 39 weeks have a higher incidence of hearing and vision problems, have more challenges nursing, are more likely to experience lung and breathing problems, and be hospitalized in the first year (http://www.ncbi.nlm.nih.gov/pubmed/22421263). But, I'm not sure how the picture looks if these data are normalized for with other indicators of maternal and fetal health (like nutrition, exercise,  or, chromosomal anomalies).

For now it seems like, without other medical indications, there isn't a strong medical case for inducing pregnancy prior to 40 weeks.

This from the girl who was born 3 1/2 weeks early, so take it with a grain of salt.

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