Monaco Statement: Considerations on Bioethics and the Rights Of The Child EJAIB 10 (2000), 71-72.

Maternal Education as a Strategy for Children's Survival and Health in Developing Countries, in Bangladesh - Wardatul Akmam EJAIB 11 (May 2001), 76-78.

A recent study in AJMG 47 (1994), 5-10; JAMA 270 (1993), 1663-4; reports that there are five places where the spinal cord must close during fetal development. Each site is susceptible to different environmental factors. On folic acid fortification in the USA, from the FDA, JAMA 270 (1993), 2283.

The limit of infant viability is the topic of M.C. Allen et al., "The limit of viability - neonatal outcome of infants born at 22 to 25 weeks' gestation", NEJM 329 (1993), 1597-601, 1649-50. They reviewed data and believe that aggressive resuscitation of infants at 25 weeks gestation is indicated, but not at 22 weeks. For in between they suggest parental, medical worker, and social discussion.

Letters on the suggested low risks of frequent ultrasound use during pregnancy are in Lancet 342 (1993), 1359-61. The risks of psychotrophic meditations during pregnancy are discussed in JAMA 270 (1993), 2177-8. The claimed link between fingerprints and fetal growth is challenged in BMJ 307 (1993), 1006.

A study in Washington state found that increased maternal age is an independent risk factor for low birth weight and preterm delivery, JAMA 270 (1993), 2574-7. A study in the US is commencing this year on the possible hazards of frequent flying and miscarriage, Science 262 (1993), 979. Fetal surgery is discussed in JAMA 270 (1993), 2025-6.

A book review of The Child's Path to Spoken Language is in Science 262 (1993), 260.

A discussion of ethical strategies for neonatal care is in B. Freund, "Neonatal intensive care and the premature infant: Criteria for intervention", Humane Medicine 257 (1993), 282-8. A discussion of the labelling of poor women to have high medical risk who seem to put their fetus at risk is SSM 38 (1994), 665-75.

The right to refuse cesarian sections in the USA is discussed in Lancet 343 (1994), 107. An defense of some enforced cesareans is in F.A. Chervenak et al., "An ethical justification for emergency, coerced cesarean delivery", O&G 82: 1029-35. This paper considers the case where there is insufficient time to seek a court order, and represents the view point that the near-delivery fetus has rights to life if is clear to be saved from the operation. Cesarian rates are discussed in Lancet 343 (1994), 179; and US infant mortality in JAMA 271 (1994), 15-6.

Another danger of silicone breast implants has been found - not to the woman but to an infant breast fed; J.J. Levine & N.T. Ilowite, "Sclerodermalike esophageal disease in children breast-fed by mothers with silicone breast implants", JAMA 271 (1994), 213-6, 240-1; Lancet 343 (1994), 229. They call for larger studies to investigate this link. A paper reporting some danger from caffeine intake by mothers to their fetuses is C. Infante-Rivard et al., "Fetal loss associated with caffeine intake before and during pregnancy", JAMA 270 (1993), 2940-3; NEJM 270 (1993), 2973-4. There are conflicting results with an earlier study, and there is debate in the medical community. A study suggesting that lithium does not present too much risk in utero is JAMA 271 (1994), 146-50.

A mouse model of neural tube defects suggests there are several factors involved in it, including inheritance; P.E. Neumann et al., "Multifactorial inheritance of neural tube defects: localization of the major gene and recognition of modifiers in ct mutant mice", Nature Genetics 6 (1994), 357-62. Letters on preventing neural tube defects include Lancet 343 (1994), 123-4, 307, 489-90. In the US all pregnant women are being advised to eat a daily multivitamin pill containing 0.4mg of folic acid, and foods will probably be fortified, BMJ 308 (1994), 223.

Studies suggest smoking in pregnancy may do more harm to the fetus than ingesting cocaine, JAMA 271 (1994), 576-7. Patterns in smoking behaviour in Christchurch, New Zealand, among pregnant women found 30% smoked during their last pregnancy; NZ Med. J. 106 (1993), 426-8. The case is made for pregnancy being a good point for smoking cessation efforts. Risk factors for small gestational age infants in NZ found smoking to be the most important, NZ Med J. 107: 71-3. A link between heart disease and low birth weight is made in Lancet 343 (1994), 260-3.

A discussion of interest is S. Fredman, "A difference with distinction: Pregnancy and parenthood reassessed", The Law Quarterly Review 110: 106-23. General book reviews including ethical aspects are in NEJM 330 (1994), 648-50. A low prevalence (16-51%) of breast feeding has been found in Scotland, BMJ 308 (1994), 824-5. Aerobic exercise by lactating women found no bad effects on milk production, and improved the cardiovascular fitness, NEJM 330 (1994), 449-53. A study on the effects of pregnancy loss on women's health is in SSM 38 (1994), 1193-200.

A link between autoantibodies and pregnancy loss is reported in Lancet 343 (1994), 747-8. A negative effect on prenatal development and IQ has been found for the drug phenytoin, D. Scolnik et al., "Neurodevelopment of children exposed in utero to phentoin and carbamazepine monotherapy", JAMA 271 (1994), 767-70. On ultrasound risks in pregnancy, Lancet 343 (1994), 178; NEJM 330 (1994), 570-2. Vitamin A and iron supplements are recommended in Lancet 343 (1994), 490-1; but low dose aspirin is recommended only for some women at risk of pre-eclampsia, Lancet 343 (1994), 619-29. Risks of alcohol consumption and fetal alcohol syndrome awareness in Alaska is reported in JAMA 271 (1994), 422-3.

Variations in cesarian rates are discussed in F.C. Notzon et al., "Cesarian section delivery in the 1980s: International comparison by indication", AJOG 170: 495-504. BMJ 308 (1994), 654; Lancet 343 (1994), 179; JAMA 271 (1994), 443-7. In Sweden the rates have declined recently. In Florida, one in four births is a cesarian, BMJ 308 (1994), 432. The ethics committee of the Royal College of Obstetricians and Gynaecologists in the UK has strongly recommended against any forced cesarians being allowed; BMJ 308 (1994), 224. This is the same as the US association.

An Institute of Medicine report in the USA has released a report, Women and Health Research: Ethical and Legal Issues of Including Women in Clinical Studies, which supports the inclusion of pregnant women in clinical trials, Science 263 (1994), 1216. At the same time the Medical University of Southern Carolina has been accused of performing illegal experiments, and unconsented drug tests on pregnant women; BMJ 308 (1994), 291-2.

On childbirth culture see SSM 38 (1994), 1125-40, 1167; BMJ 308 (1994), 342. A US study finds black women get less prenatal care, BMJ 308 (1994), 290-1. A study finding parental neglect in childhood increases the risk of obesity in young adulthood is Lancet 343 (1994), 324-7.

The FDA at the end of 1993 proposed folic acid fortification of all bread and grain products, and the difficulties are discussed in FDA Consumer (May 1994), 11-4. Folic acid is discussed in Lancet 343 (1994), 923. Spontaneous abortion is a high risk factor for neural tube defects in the next pregnancy, AJMG 51 (1994), 93-7. Screening for neural tube defects is discussed in MJA 160 (1994), 384. The development of the baby brain is discussed in Science 264 (1994), 1080-3.

In addition to the papers and comment by Frank Leavitt in the front of this newsletter of fetal surgery, a review is N.S. Adzick & M.R. Harrison, "Fetal surgical therapy", Lancet 343 (1994), 897-901.

A study in the Amer. J. Epidemiology (15 June 1994) suggests that women who smoke damage the lungs of their babies. The use of surfactant has led to decreased mortality in low weight babies in NEJM 330 (1994), 1476-80. Letters on the viability of babies born at 22-25 weeks are in NEJM 330 (1994), 1234-6; AJOG 170 (1994), 1266-70; also Brit. J. Obs. & Gyn. 101: 369-70.

A study suggesting the use of aspirin in pregnancy is safe is in Lancet 343 (1994), 1235. Letters on birth weight and cocaine use are in JAMA 271 (1994), 1161-2; and on defects due to arsenic, Science 264 (1994), 204. A review of the Cochrane Pregnancy and Childbirth Database (on disc) is in BMJ 308 (1994), 1448. Birth weight appears to be linked to diabetes in some populations, BMJ 308 (1994), 942-5; but not to systolic blood pressure in adolescence, BMJ 308 (1994), 1074-7. Trends in birth weight are reported in BMJ 308 (1994), 1270-1.

Prenatal advice appears to lower risk of miscarriage, in a USA program, M.D. Kogan et al., "Relation of the content of prenatal care to the risk of low birth weight. Maternal reports of health behavior advice and initial prenatal care procedures", JAMA 271 (1994), 1340-5. The compliance of mothers to give vitamin K to their newborns was found to be poor in a UK study, BMJ 308 (1994), 894-5, 867-8. A report on the incidence of smothering of babies by their mothers is Lancet 343 (1994), 1354. Lead poisoning screening by capillary sampling is reported in JAMA 271 (1994), 1346-8.

A paper arguing against keeping dead pregnant women as fetal incubators is H.L. Nelson, "The architect and the bee: Some reflections on postmortem pregnancy", Bioethics 8 (1994), 247-67. A study suggesting fetal stress in receiving in utero transfusion is Lancet 344 (1994), 73-4. One imagines the stress of a maternal death is not insignificant. A study suggests the fetus does mount a hormonal stress response to intrauterine needling, Lancet 344 (1994), 77-81.

A higher rate of multiple births is reported after vitamin supplements, that are encouraged to avoid spina bifida, NEJM 330 (1994), 1687-8. In most woman an increase in non-haem iron absorption occurs in pregnancy which is sufficient in a normal diet, BMJ 309 (1994), 79-82. A low risk of in-utero radiation exposure in atomic bomb survivors is reported in Lancet 344 (1994), 345-6, however also see the section on Disease Risks above. High rise apartments have been linked to miscarriage in Japan, New Scientist (13 Aug 1994), 7.

Smoking during the third trimester results in reduced fetal growth, AJPH 84 (1994), 1127-31; and raises the relative odds of limb defects, BMJ 308 (1994), 1473-6. Letters on fetal loss and caffeine intake are in JAMA 272 (1994), 27-9. The possible ill effects of zidovudine therapy against HIV during the first trimester of pregnancy need further monitoring, JAMA 272 (1994), 17. Risks of alcohol are discussed in JAMA 271 (1994), 1820-1; and lithium in JAMA 271 (1994), 1829-30. Book reviews of interest include: New Scientist (18 July 1994), 43.

A discussion of risks of delayed childbearing concluding that the risks are manageable is MJA 160 (1994), 539-44. The results of Arizona surveys of the use of family planning services and health insurance are in AJPH 84 (1994), 1010-2. A study finding more risks of inadequate care in Washington state compared to British Columbia is S.J. Katz et al., "The adequacy of prenatal care and incidence of low birthweight among the poor in Washington State and British Columbia", AJPH 84 (1994), 986-91. Treatment of maternal toxoplasmosis by antiparasitic treatment and ultrasound monitoring is encouraged, over abortion, in Lancet 344 (1994), 36-9.

Cesarians are thought to half the actual risk of HIV transmission to the baby, Lancet 343 (1994), 1464-7. The management of labour is reviewed in "World Health Organization partograph in management of labour", Lancet 343 (1994), 1399-1404. A study on the uptake of foods in breast feeding infants is Lancet 344 (1994), 288-93. Letters on breast feeding and breast cancer are in NEJM 330 (1994), 1682-5. No association between breast cancer and last birth was observed in one US study, BMJ 308 (1994), 1672-4; while in another a transient rise was reported, NEJM 331 (1994), 5-9.

A letter recommending testing the zygosity of twins is Lancet 343 (1994), 1577, and on fetal RhD typing, Lancet 344 (1994), 205-6.

The Medical University of South Carolina and the federal office of Civil Rights are discontinuing a policy of threatening with arrest pregnant women who test positive for drugs; Reproductive Freedom News (23 Sept 1994), 4. Adverse effects of cocaine, lead, and nicotine, are reported in AJPH 84 (1994), 1492-5; and in epileptic drug treatments, JAMA 272 (1994), 851-2; and of abuse of the mother, O&G 84 (1994), 323-8; but alcohol is less clear, AJPH 84 (1994), 1421-8. On fetal stress, Lancet 34: 615, 628-9.

Reduced birthweight is reported in families where only the man smokes, Martinez F.D. et al. "The effect of paternal smoking on the birthweight of newborns whose mothers did not smoke", AJPH 84 (1994), 1489-91. A study of smoking women found nicotine and cadmium from the smoke in the fluid around the mature eggs, and this may lead to chromosome abnormalities which result in miscarriage, in a paper at the Amer. Society of Human Genetics October, 1994 meeting. The effects of nicotine are claimed to even to cause fetal addictive behaviour in a study, Kandel, D.B. et al. "Maternal smoking during pregnancy and smoking by adolescent daughters", AJPH 84 (1994), 1407-13. fears that pollutants are damaging the reproductive system itself are discussed in Time (19 Sept), 40-2.

In general fetal life and adult health are linked, AJPH 84 (1994), 1372-5, and linked to mothers health. On calcium supplements, Brit.J. O&G 101 (1994), 753+; A study finding no clear evidence for a link between breast feeding and longevity is AJPH 84 (1994), 1458-62. An argument that speech can be learned in prenatal stages is Seevach, B.S. et al. "A model of prenatal acquisition of speech parameters", PNAS 91 (1994),, 7473-6.

A call for further study of the effects of extremely low birth weight is in Hille, E.T.M. et al. "School performance at nine years of age in very premature and very low birth weight infants: Perinatal risk factors and predictors at five years of age", J. Pediatrics 125: 426-34. A study showing adverse effects is Saigal, S. et al. "Comparison of the health-related quality of life of extremely low birth weight children and a reference group of children at age eight years", J. Pediatrics 125: 418-25; see also pp. 411-7; Hack, M. et al. "School-age outcomes in children with birth weights under 750g", NEJM 331 (1994), 753-9, 802-3.

In general on prenatal care: AJPH 84 (1994), 1450-7, 1511-4; and low birth weight, O&G 84 (1994), 485-9; JAMA 272 (1994), 853-8, 890-1; Lancet 344 (1994), 597. The costs of US perinatal care are estimated in AJPH 84 (1994), 1473-8. A study reporting both higher perinatal risk and more favourable birth outcomes among Asian Americans is AJPH 84 (1994), 1497-500; and on birth weight differences among US Asians, AJPH 84 (1994), 1444-9 (one wonders whether this is height related!). On racial differences, AJPH 84 (1994), 1505-7, 1521-2; O&G 84 (1994), 490-5.

Cesarian sections are discussed in JAMA 272 (1994), 524-9, 558-9; O&G 84 (1994), 574-8; BMJ 309 (1994), 366-9.

A series of papers on the paternal-fetal conflict is in Politics & Life Sciences 13: 249-64. Social factors which influence pregnancy are discussed in MJA 161 (1994), 463-4, 473-7; and domestic violence is one extreme, MJA 161 (1994), 466-70. The cessation of breast feeding has positive effects on mental health, Forster, C. et al. "Psychological and sexual changes after the cessation of breast- feeding", O&G 84 (1994), 872-6. The cost savings of prenatal care make the case for improvements even if direct ethics don't, NEJM 331 (1994), 1303-7.

A study finding that Mexican Americans were more than 3 times likely to quit smoking in pregnancy than non-Hispanic whites is Camilli, A.E. et al. "Smoking and pregnancy: A comparison of Mexican-American and Non-Hispanic white women", O&G 84 (1994), 1033-7. A study suggesting that cigarette smoking does not affect chances of successful IVF is F&S 62 (1994), 807-14. A longer period of sexual cohabitation before pregnancy reduces the chance of hypertension in pregnancy, Lancet 344 (1994), 973-5.

A Canadian legal report is Oliver, J. "State intervention during pregnancy and childbirth: The newest challenge to women's reproductive freedom", Health Law Review 2: 3-10; and a US view, Seymour, J. "A pregnant women's decision to decline treatment: How should the law respond?", J. Law & Med. 2: 27-37. Fetal alcohol syndrome in Australia is still a serious problem, MJA 161: 461-2. A study in Italy finds that one or two drinks a day does not increase miscarriage rate in the first trimester or even later, Human Reproduction 9 (1994), 1950-3. The results of a TV campaign in Canada found some effect, CJPH 85: 23-7.

First trimester exposure to anesthesia brings some risks to the central nervous system, AJPH 84 (1994), 1757-60. A study finding that 6% of women visiting hospital are pregnant and don't know it means more care needs to be taken, JAMA 272 (1994), 1241. Care should be taken with tamoxifen, BMJ 309 (1994), 1313-4.

Studies of children who survived childhood cancer finds no evidence of mutagenesis of germ cells, BMJ 309 (1994), 1034.

Folic acid supplements are discussed in CMAJ 151 (1994), 15-6, 151+; Lancet 344 (1994), 1578-9. The position of the fetus in the uterus of mice affects the sex ratio of her offspring in an interesting finding, PNAS 91 (1994),, 11055-9. Twinning is discussed in PNAS 91 (1994),, 11363-7; AJMG 53 (1995), 52-5; and a review on implantation is Cross, J.C. et al. "Implantation and the placenta: key pieces of the development puzzle", Science 266 (1994), 1508-7.

Breast-feeding is increasingly being shown to have health benefits for babies, Lanting, C.I. et al. "Neurological differences between 9-year old children fed breast-milk or formular-milk as babies", Lancet 344 (1994), 1319-22, 1239-41. On managing mothers at risk of low birthweight babies, CMAJ 151 (1994), 547-9; JAMA 272 (1994), 1257-62. Research to stop premature babies is reviewed in Science 266: 1486-8. The efforts in reducing the risks of sudden infant death syndrome are being increased in the USA, JAMA 272 (1994), 1646. Obesity is discussed in AJPH 84 (1994), 1727-8.

Neonatal drug testing is discussed in Health Law Review 2: 11-6.

The possible immunosuppressive effects of pregnancy and breast cancer increase are debated in Lancet 344 (1994), 1235-6. Pregnancy and ovarian cancer is debated in Lancet 344 (1994), 1250-4. Life without estrogen is discussed in NEJM 331 (1994), 1088-9.

Cesarians are discussed in O&G 84 (1994), 832-8; Mello E. Souza, C.A. "C-sections as ideal births: The cultural constructions of beneficence and patient rights in Brazil", CQHE 3 (1994), 358-66; and on epidural injection side effects, Lancet 344 (1994), 1218.

A summary of international studies on wife abuse revealing 20-60% reported abuse is IN/FIRE Ethics 3 (No.3&4, 1994), 11-2.

The need for prenatal care and California plans to stop health care to "illegal" immigrants is expected to cost much more money caring for the children later, JAMA 272 (1994), 1889. Also on prenatal care, BMJ 310 (1995), 36-8. On the low infant health in the USA, JAMA 272 (1994), 1803-4. Cot deaths are reviewed in several countries in BMJ 310 (1995), 7-10, 88-90; and unproven claims about plastic mattresses is BMJ 309 (1994), 1594-5.

Shorter intervals between births is shown to have negative impacts on infant health in NEJM 332 (1995), 69-74, 117-8. A Chinese study has also found iodine deficiencies affect infant IQ, Cao, X.Y. et al. "Timing and vulnerability of the brain to iodine deficiency during fetal development", NEJM 331 (1994), 1739-44, 1770-1;BMJ 310 (1995), 148. Homocysteine metabolism suggests vitamin B12 as well as folic acid are useful for avoiding neural tube defects, Lancet 345 (1995), 149-51. A general call for 0.4mg of folic acid per day for all reproductive years is AJMG 55: 134-5; Lancet 344 (1994), 1696.

A study has found that mild maternal hyperphenylalaninaemia does not seem to have a serious affect on the fetus, Lancet 344 (1994)1589-94. A link with infant weight and heart disease later in life is confirmed in BMJ 310 (1995), 17-9. See also BMJ 310 (1995), 68-9; Lancet 345 (1995), 309. Letters on cohabitation and pregnancy-induced hypertension are in Lancet 344 (1994), 1633-5.

Cesarean sections are discussed in Lancet 345 (1995), 142. On childbirth in general, BMJ 310 (1995), 144.

Italy has Europe's highest cesarian section rate, at 22.4%, following the USA and Brazil, BMJ 310 (1995), 487. In the UK women requesting a home birth are calling for more freedom, BMJ 310 (1995), 212; as they are in Japan where very few give birth at home, Japan Times (26 March 1995), 3. On the profession of midwifery, Lancet 345 (1995), 532-3.

A report on the trends among women who did not receive prenatal care in the USA in 1992 is JAMA 273 (1995), 616. They had lower birth weights, preterm deliveries and higher maternal and infant mortality. See also AJPH 85 (1995), 26-9. A book review of The Fetus as a Patient: Advances in Diagnosis and Therapy is NEJM 332 (1995), 478. A low hemoglobin concentration (<105g/l) is associated with increased chance of low birth weight, BMJ 310 (1995), 489-91. A study of mortality of twins is BMJ 310 (1995), 432-6. Also on obstetrics and gynecology, NEJM 332 (1995), 477-8.

A paper on the legal response to a pregnant's woman's refusal of medical treatment is J. Law & Med. 2 (1994), 27-37; and on depressed neurodevelopment of adopted children children exposed in utero to cocaine, CMAJ 151 (1994), 1591+. Letters on folic acid to avoid neural tube defects are in Lancet 345 (1995), 389-90; 378. A higher incidence of neural tube defects is also found in women who have had spontaneous abortions, AJMG 55: 512. The UK has decided not to ban adverts for baby milk formulas, BMJ 310 (1995), 284. Abuse of pregnant women is discussed in CMAJ 151 (1994), 1601+.

A review of the dangers of antimony in baby mattresses and cot death is NZMJ 108: 69-70. A letters on following up studies of preterm babies is Lancet 345 (1995), 447.

An economic analysis of folic acid fortification of grain is AJPH 85 (1995), 667-76. A call for policy in the UK is BMJ 310 (1995), 1019-20; and in Australia, MJA 162 (1995), 403-6; and in South Carolina, USA, JAMA 273 (1995), 1485. In utero surgery on sheep rescued neurological function for spina bifida, Nature Medicine 1 (1995), 342-7.

Management of high risk pregnancies is discussed in BMJ 310: 882-3. On management of first trimester spontaneous abortion, Lancet 345 (1995), 1179-80. The natural killer cell count can be a predictor of risk of miscarriage in women with a history of miscarriage, Lancet 345 (1995), 1340-2.

Radiation exposure of women of child-bearing age should be avoided outside of the first 10 days of the period, BMJ 310 (1995), 1022-3. The deficits in infant weight among mothers who smoke are overcome after 6 months, BMJ 310 (1995), 768-71. A chromosome paint for abnormalities can identify smokers, both passive and active, NS (1 April 1995), 20. Fetal alcohol syndrome is discussed in JAMA 273 (1995), 1406-8. Discussion of the mutagenicity of thalidomide is in Nature 375 (1995), 453. Attitudes to weight gain during pregnancy are reported in O&G 85 (1995), 590-5. Low weight is not always a risk, JAMA 273 (1995), 709-11.

Racial differences in cesarian rate are reported in AJPH 85 (1995), 625-30. On vaginal birth after cesarians, Lancet 345 (1995), 725-6. Review of the results of neonatal intensive care include BMJ 310 (1995), 681-2; JAMA 273 (1995), 739-40; AJPH 85 (1995), 300-2; MJA 162 (1995), 295-9. A UK report found that 40% of deaths in healthy babies in neonatal care units were linked to suboptimal care, BMJ 310 (1995), 757. On use of umbilical cords in research, Science 268 (1995), 805.

A Nepalese study of training of staff in teaching of proper breast feeding practice is in BMJ 310 (1995), 621-3. A link between literary and better baby care is made in NS (29 April 1995), 8. Cot death or sudden infant death (SID) syndrome and plastic mattresses are discussed in Lancet 345 (1995), 720; and the link with antimony, BMJ 310 (1995), 1216-7. The change in sleeping position is, however, the most significant identified risk factor in Tasmania, Australia but not in California, JAMA 273 (1995), 783-9, 790-4, 818-9. Passive smoking also is a risk factor, JAMA 273 (1995), 795-8.

A discussion of the ethics of cocaine use is Jos, P.H. et al. "The Charleston Policy on cocaine use during pregnancy: cautionary tale", JLME 23 (1995), 120-8.

Rantakallio, P. et al. "A 28 year follow up of mortality among women who smoked during pregnancy", BMJ 311 (1995), 477-80. Peacock, J.L. et al. "Preterm delivery: effects of socioeconomic factors, psychological stress, smoking, alcohol, and caffeine", BMJ 311 (1995), 531-5. Adverse social circumstances are associated with preterm birth but smoking is not, apart from an association with very early births. Women experiencing adverse socioeconomic factors during pregnancy are more likely to deliver early.

A black/white study in the USA on maternal smoking is in SSM 41 (1995), 227-33; and on attitudes to weight gain, O&G 86 (1995), 177-83. Efforts to increase the birth weight of Indian British babies are called for in BMJ 311 (1995), 86-8. The relationship between interval between pregnancies and low birth weight is discussed in NEJM 332 (1995), 386-7. Maternal growth during adolescent pregnancy is higher, JAMA 274 (1995), 26-7. The results of premature infants born in Victoria are more favourable then in many countries, MJA 163 (1995), 11-4. The US regulators are discussing the early discharge of mothers from hospitals to save money, Lancet 346 (1995), 171-2; Newsweek (24 July, 1995), 55.

Nestle is on trial in India, BMJ 311 (1995), 348. A paper on the Japanese concepts of motherhood is Miyagi, N.T. & Lock, M. "Monitoring motherhood: Sociocultural and historical aspects of maternal and child health in Japan", Daedalus 123 (No.4, 1994), 87-112. An study Australian study available on an on-line journal is Evans, M.D.R. & Kelley, J. "The effect of mother's employment on her children's education: Australian evidence", Worldwide Attitudes (7 August, 1995). The study finds mixed results with both benefits and costs.

Letters on neural tube defects and twinning are AJHG 57 (1995), 193-7; and on folic acid's role, BMJ 311 (1995), 256-7. A 20-25% reduction in another type of disorder is also reported with vitamins are Shaw, G.M. et al. "Risks of orofacial clefts in children born to women using multivitamins containing folic acid periconceptionally", Lancet 346 (1995), 393-6.

The use of zinc to increase birth weight in women with low plasma concentrations is shown in JAMA 274 (1995), 463-8. Fetal origins of coronary heart disease are reviewed in BMJ 311 (1995), 171-4. A review of the decision in the USA to keep isotretinoin on the market but to require stronger warnings against use during pregnancy, with extrapolations to these types of drugs is NEJM 333 (1995), 124-5. A review is Garner, P. "Type I diabetes mellitus and pregnancy", Lancet 346 (1995), 157-61; and on tuberculosis in pregnancy, Lancet 346 (1995), 199. On EMF radiation exposure in pregnancy during sewing, Lancet 346 (1995), 177.

The funding of maternity in New Zealand is constrained by a tight budget, Lancet 346 (1995), 366. Recurrent pregnancy loss and cytokines are discussed in JAMA 273 (1995), 1958-9. The question of whether laparoscopy is associated with ovarian cancer is discussed in Lancet 346 (1995), 200. On sudden infant death syndrome, SA (August 1995), 22-4.

The terminology of cesarians is discussed in O&G 86 (1995), 152-3. Female genital mutilation in Britain is reviewed in BMJ 311 (1995), 1590-4.

In The US state of Wisconsin an appeal court has upheld a ruling that a viable fetus should be protected, for example against drug abuse, and a women may be held in custody to avoid drug exposure, Reproductive Freedom News (19 Oct, 1995), 4. Pregnancy in mothers with cystic fibrosis have improved outcomes, BMJ 311 (1995), 822-3; as do diabetic mothers, Lancet 346 (1995), 896.

A paper on the relationships between doctors and patients is Daniels, K.R. et al. "Relationships between doctors and patients in obstetrics and gynaecology", Aust. NZ. J. Obstet. Gynaecol. 35 (1995), 286-9. On looking at which part of prenatal care is of most benefit, JAMA 274 (1995), 611-2.

A survey by Gallup for the March of Dimes in the USA of women aged 18-45 years found 52% had heard of folic acid, of these 9% answered that it helps to reduce risks of birth defects and 6% said for spina bifida, but 45% did not know where they had heard or what. 88% said that a woman could reduce the risk for having an infant with birth defects, with 73% saying by reducing alcohol or drugs, 63% by not smoking; JAMA 274 (1995), 1190. A letter on requests for folic acid is Lancet 346 (1995), 973; and on the use of folic acid to decrease vascular disease risk, JAMA 274 (1995), 1049-57; and cleft lip, Lancet 346 (1995), 1037.

A study of older pregnancies finds that the successful live birth rate in women over 35 years old in Canada is 99.6%; Fretts, R.C. et al. "Increased maternal age and the risk of fetal death", NEJM 333 (1995), 953-7, 1002-3. There are dangers in young mothers also, NEJM 333 (1995), 800-1.

A view that there is a move by doctors to pursue the practice of independent mid-wives and the home-birth movement is Wagner, M. "A global witch-hunt", Lancet 346 (1995), 1020-2. Active manage-ment of labour was not found to reduce the cesarian rate in a US study, but it did shorten labour time, NEJM 333 (1995), 745-50. On the safety of intrapartum electronic monitorring, O&G 86 (1995), 613-20. Definitions of still birth are debated, Lancet 346 (1995), 486-8.

See the paper by Irina Pollard in this issue; EJAIB 6 (1995), 2-7. A discussion of how to regulate treatment for pregnant drug abusers is D. Mathieu, "Mandating treatment for pregnant substance abusers: A compromise", ?", Politics & Life Sciences 14 (1995), 199-208. While she agrees that mandatory state treatment is not-justified, she explores situations where it could be. In New Zealand a divorced father has been denied access to children if he smokes in their presence, Christchurch Press (21 Dec 1995), 3. One of the children has asthma.

A US study has found that lifelong changes occur in women who have been pregnant, with increased ability to detoxify caffeine, and other compounds, by expression of cytochrome P450-1A2, NS (21 Oct 1995), 18. Long-term detrimental effects of exposure to phenobarbital are shown in Reinisch, J.M. et al. "In utero exposure to phenobarbital and intelligence deficits in adult men", JAMA 274 (1995), 1518-25. A summary of the adverse effects of dioxin is Lindstrom, G. et al. "Workshop on prenatal exposure to dioxin-like compounds. I. Summary", Environmental Health Perspectives 103 (1993), 135-42; and there is also a paper on reproductive effects, pp. 143-5. A possible link between low weight gain in infancy and suicide in adult life is investigated in BMJ 311 (1995), 1203. A WHO Collaborative Study is Maternal Anthropometry and Pregnancy Outcomes, Supplement to Bulletin of WHO 73 (1995), c100pp. Papers on telephone counseling and medical advice in pregnancy are in NZMJ 108 (1995), 315-7, 476-8.

Research revealing why so many embryos have a chromosome mistake in egg cell meiosis is discussed in NS (21 Oct 1995), 20. About 1% of all embryos have an extra #16 chromosome, and such embryos are spontaneously aborted. Monitoring of birth defects needs to be done carefully to check causes, World Health Forum 16 (1995), 398-9; Public Health Reports 110 (1995), 154-60. The reasons why women who smoke during pregnancy die earlier may be that they are heavy smokers, Student BMJ 311 (1995), 477-80. The FDA has called FDA a pediatric disease, Nature Medicine 1 (1995), 983-4. Fetal alcohol syndrome in New Zealand is reviewed in NZMJ 108 (1995), 502-5.

The use of antibody may decrease rejection of rhesus babies, NS (14 Oct 1995), 22; see also Science 270 (1995),6 30-3. On the competitive aspects of the fetal-mother relationship, SA (Dec 1995), 25-6. In New Zealand at New Year a baby was born from a woman who died in traffic accident a few days earlier, Christchurch Press (4 Jan 1995), 1. A recommendation to pregnant women to wear seatbelts is in BMJ 311 (1995), 1501. Fetal surgery is becoming increasingly successful, BMJ 311 (1995), 1449-50; and heart surgery is reported in AJOG 173 (1995), 1384-90.

Calls to increase folic acid consumption are made in JAMA 274 (1995), 1717-8; AJPH 85 (1995), 1587-8. An increased folic acid intake of 0.4mg per day would decrease neural tube defects in the USA by 48%, JAMA 274 (1995), 1698-702. Additional benefits include reduced conotruncal heart defects and limb defects, AJMG 59 (1995), 536-45. On vitamin A and reducing birth defects is NEJM 333 (1995), 1414-5. A study in the UK finds pregnant women eat badly, BMJ 311 (1995), 1390.

A German legal case on rights of pregnant women to work is in Modern Law Review 58 (1995), 860-6. The decreasing number of women in Swaziland who breast feed is documented in NS (7 Oct 1995), 44-5. The rates in New Zealand are reported in NZMJ 108 (1995), 355-7. The benefits of breast milk for the immune system are described in SA (Dec 1995), 76-9. The perception of protecting women and children first is discussed in NEJM 333 (1995), 1647-51.

The USA has decided to fortify wheat, cereals, breads and breakfast cereals with folic acid. A discussion of the benefits of folic acid and the dangers of elevated homocysteine levels is AJHG 57 (1996), 17-20. The finding that a 677C to T mutation of methylenetetrahydrofolate reductase gene is three times higher in parents of babies with spina bifida is confirmed in Lancet 347 (1996), 1703. See also Lancet 347 (1996), 321-2. Zinc supplementation is debated in JAMA 274 (1995), 1909-10; and a criticism of a Lancet preview of a NEJM paper on vitamin A and birth defects is Lancet 347 (1996), 321-2. Preventing iron deficiency can be obtained by placental transfusion, BMJ 312 (1996), 136-7.

A paper finding familial trends in birth weight in the USA is Wang X. et al. "Familial aggregation of low birth weight among whites and blacks in the United States", NEJM 333 (1995), 1744-9, 1772-3. There are differences between races, SSM 42 (1996), 589-97. The US National Reference for fetal growth is in O&G 87 (1996), 163-8; and a Jamaican study on fetal growth and cardiovascular risk is BMJ 312 (1996), 156-60. A call for the World bank to promote maternal health is Lancet 346 (1995), 1711; also, NS (17 Feb 1996), 6.

Accelerated lung maturity in the fetus is associated with cocaine or tobacco use, O&G 87 (1996), 128-32. A review of research on adverse effects of prenatal alcohol exposure is AJPH 85 (1995), 1614-5. A recommendation that infants sleep in the same room as parents to reduce risk of sudden infant death syndrome is based on studies of parents who do this, Lancet 347 (1996), 2, 7-12; see also Lancet 346 (1995), 1503.

A review of recent fetal surgery is in Lancet 346 (1995), s18.

On women's health, O&G 87 (1996), 1-5; and hormone replacement therapy, O&G 87 (1996) Supplement, 1S-50S. Results of mothers giving natural birth after a first cesarean encourage the attempt for natural birth first, Lancet 347 (1996), 278; and an ethical approach for choice is discussed in Chervenak FA & McCullough LB, "An ethically justified algorithm for offering, recommending, and performing cesarean delivery and its application in managed health care practice", O&G 87 (1996), 302-5. There has been wide criticism of shackling women in prison in the UK when giving birth, BMJ 312 (1996), 200.

A debate on whether there should be a trial of home versus hospital birth in the UK is in BMJ 312 (1996), 753-7. Clinical trials of active management of labour are debated in NEJM 334 (1996), 797-9. A study of 89,887 women has shown no association between breast feeding and breast cancer incidence, Lancet 347 (1996), 431-6. Overwieght mothers put babies at more risk, NS (20 April 1996), 8.

Folic acid fortification of food (BMJ 312 (1996), 599) may have benefits beyond that of less incidence of spinal cord defects in babies, JAMA 275 (1996), 681-3. A study suggesting that supplementary folic acid is more effective than dietary form, Lancet 347 (1996), 657-9.

Reproductive Health Care is reviewed in NEJM 334 (1996), 868-9; and of the health of mothers and antenatal visits, MJA 164 (1996), 198-9; Lancet 347 (1996), 769; BMJ 312 (1996), 524-5, 546-53, 554-9; JAMA 275 (1996), 847-51. Violence against women is an avoidable problem in many parts of the world, AJPH 86 (1996), 12-7; JAMA 275 (1996), 973-4. A review of abuse against women showing that women who ere abused had a birth weight of babies 133g less than others, Nursing Research 45 (1996), 37-41. Neurological problems of premature birth are described in NEJM 334 (1996), 857-8.

An extensive review of links between fetuses and drug exposure is Quiesser-Luft, A. et al. "Serial examination of 20,248 newborn fetuses and infants: Correlations between drug exposure and major malformations", AJMG 63 (1996), 268-76. They did not find teratogenic risks or specific associations, but found a statistical associations between antiallergics and heart anomalies and musculoskeletal anomalies, for bronchodilators and heart anomalies, for antiepileptics and anomalies of the internal urogenital system, and cleft lip, and for thyroid hormones and nervous system anomalies. On pollutants and fetuses, BMJ 312 (1996), 1497-8; Nature 381 (1996), 457; JAMA 275 (1996), 1066-7.

A symposium involving numerous authors on pregnancy and substance abuse is in Politics & Life Sciences 15 (1996), 49-81. Babies born after heroin exposure prenatally can develop as well as those not exposed if moved to adoption of foster homes, Lancet 347 (1996), 1397.

A study on the links to later life is Martyn CN. "Growth in utero and cognitive function in adult life: follow up study of people born between 1920 and 1943", BMJ 312 (1996), 1393-6. There seems to be little link between breast feeding and dummy use and intelligence in later life that is not explained by social class, Lancet 347 (1996), 1057, 1072-5. In multifetal pregnancies it is recommended to estimate the delivery date at 37-38 weeks to avoid the higher risk of fetal death, JAMA 275 (1996), 1432-4. A discussion and paper looking at pregnancy outcomes of Australian aboriginals and Torres Strait Islanders is MJA 164 (1996), 516-7, 523-6.

French health authorities have yet to promote the benefits of folic acid, NS (25 May 1996), 11. Obese women also have increased risk of fetuses with neural tube defects, JAMA 275 (1996), 1089-92, 1093-6, 1127-8. In areas of iodine deficiency, iodine oil can be used in a WHO statement, Bulletin WHO 74 (1996), 1-3. A discussion and review is Harrison, MR. "Fetal surgery", AJO&G. 174 (1996), 1255-64.

A response to female genital mutilation is Lane, SD. & Rubinstein, RA "Judging the other: Responding to traditional female genital surgeries", HCR 26 (May/June 1996), 31-40. A study of peer review on cesarean rate found no effect, O&G 87 (1996), 664-7. Also on cesareans, BMJ 312 (1996), 1433-4, 1451-4; Lancet 347 (1996), 1196. Letters on length of stay for mothers and newborns are in NEJM 334 (1996), 1134-5; and a criticism of hospitalization of birth is NS (11 May 1996), 5. A discussion of circumcision is in J.Med.&Phil. 21 (1996), 137-48.

Prenatal folic acid in mice suppresses acrania and meroanencephaly in a mouse model of neural tube defects, Nature Genetics 13 (1996), 275-83; Lancet 348 (1996), 58, 185, 419-20. Low serum levels of folate are associated with higher risk of heart attack, Morrison, HI. et al. "Serum folate and risk of fatal coronary heart disease", JAMA 275 (1996), 1893-6, 1929-30. A clinical trial is being called for as it may benefit adult health also. On vitamins in early pregnancy BMJ 313 (1996), 128-9.

Discussion of whether drinking in pregnancy is murder is in BMJ 313 (1996), 645. A stressful fetal live may be linked to a stressful life, NS (22 June 1996), 19. On increasing health links between fetus and adult, Lancet 348 (1996), 535. If there are any effects of multiple ultrasound and baby size they appear to be gone by one year, Lancet 348 (1996), 482. On any links between in utero exposure to stilboestrol and breast cancer, Lancet 348 (1996), 331. On book review on bendectin and birth defects is in Science 273 (1996), 196. Preconceptional radiation exposure from Chernobyl in Greece appears not to have influenced leukemia, but in utero a 2.6 times high rate was seen, Petridou, E. et al. "Infant leukaemia after in utero exposure to radiation from Chernobyl", Nature 382 (1996), 352-3.

The failure of preventing preterm birth is reviewed in AJPH 86 (1996), 781-3. Giving birth after pregnancy in space has been found to be more difficult and the baby rats were disorientated by gravity, NS (13 July 1996), 9. Discharge of mothers from hospital after birth is discussed in JAMA 275 (1996), 1823-4. A survey rate of pregnancy-related death in the USA was 1 in 10,000 live births in 1990; O&G 88 (1996), 161-7. On health status of preterm infants as they grow up, JAMA 276 (1996), 453-9, 492-3. More males are born preterm than females, O&G 88 (1996), 189-93. A study on cesarean rates is Brown, HS. "Physician demand for leisure: Implications for cesarean section rates", J. Health Economics 15 (1996), 233-42.

Letters on slight advantages of breast feeding compared to dummy use in adult intelligence are in Lancet 347 (1996), 1764-6. Hospital rates within Canada vary widely, CMAJ 155 (1996), 181+. Two studies on the risk of the sudden infant death syndrome are BMJ 313 (1996), 191-4, 195-9. The link between Vitamin K and childhood cancer is studied in Germany in BMJ 313 (1996), 199-202. On environmental estrogens, EST 30 (1996), 331A; SA (Sept 1996), 178, 180.

On the dilemmas of Siamese twins, Thomasma, DC. et al. "The ethics of caring for confronted twins. The Lakeberg twins", HCR 26 (July/August 1996), 4-12.

California has made female genital mutilation a criminal offense, in bill AB2125, on Sept. 22 when the governor signed it. Egypt has banned any government affiliated medical staff from performing it, Monash Bioethics Review 15 (Oct. 1996), 6. Estimates on the proportion of Egyptian women who have had it done is 70-97%. On African opposition to moves to stop it, Newsweek (14 Oct 1996), 67.

US President Clinton signed a mandatory 48 hour childbirth stay into law in the USA to try to make sure poorer mothers could also recover in hospital, on 26 Sept, 1996. Black infants born preterm after premature rupture of membranes have a better survival rate than whites in a Chicago hospital study, O&G 88 (1996), 356-63. A review of the growing number of single mothers who are supported by social welfare, SA (Oct 1996), 60-7. A new method for partial liquid ventilation has had positive results for premature babies, NEJM 335 (1996), 761-7, 814-5. Breast milk substitute use is not primarily linked to mother's employment in developing countries, AJPH 86 (1996), 1235-40.

Maternal smoking during pregnancy is a risk factor for attention deficit hyperactivity disorder in children, Am. J. Psychiatry 153 (1996), 1138-42. . A Polish study suggests that air pollution can stunt the growth of fetuses, NS (19 Oct. 1996), 4. In Canada, the Manitoba Court of Appeal has decided there is no right to confine a 22 year old women who has a solvent sniffing habit, for fears of brain damage to the baby, Lancet 348 (1996), 816. On the benefits of folic acid during pregnancy, FDA Consumer (Sept 1996), 7-10; Am. J. Clin. Nutrition 63 (1996), 520-5 and on a UK educational program, Lancet 348 (1996), 818. Varicella vaccine is recommended in pregnancy, BMJ 313 (1996), 701-2. On drugs for depression in pregnancy, NEJM 335 (1996), 1056-8

The attempts in the USA to reduce the cesarean rate are reviewed in NEJM 335 (1996), 689-95, 735-6. There have been two cases in the UK and Wales where a cesarean as been court ordered, Lancet 348 (1996), 770; BMJ 313 (1996), 705. In the USA, concentration of high risk pregnancies into fewer hospitals has been calculated to decrease neonatal mortality rates, JAMA 276 (1996), 1054-9. A study suggesting strokes are more frequent 6 weeks after giving birth, but not otherwise in pregnancy is NEJM 335 (1996), 768-74.

A Chinese baby boy that has two brains is surviving but cannot sleep much because the two brains work in rotation, Reuters, 14 Oct 1996. The boy was born in Chaoyang city in Lianing province in July 1995, and he does not need surgery.

Access to prenatal care in New York City was measured through a telephone survey of clinics, which found the waiting time between telephone call and appointments was 2-7 weeks, AJPH 86 (1996), 1474-5. A study of the cost effectiveness of cesareans for fetal macrosomia is JAMA 276 (1996), 1480-6. Female circumcision or so-called genital mutilation has been outlawed in the USA, BMJ 313 (1996), 1103; Reproductive Freedom News (25 Oct 1996), 5-6.
Smoking in pregnancy may cause limb defects, AJPH 87 (1997), 29-32. Neonatal risk factors for cerebral palsy in very preterm babies are reported, BMJ 314 (1997), 404-8. In utero exposure to tricyclic antidepressant drugs or fluoxetine does not affect IQ, NEJM 334 (1997), 258-62. On decreasing birth defects, FDA Consumer (Dec 1996), 12-7. Inositol can prevent folate-resistant neural tube defects in mice, NatMed 3 (1997), 24-5, 60-6. On the genetics of folate, AJHG 60 (1997), 433-8. On gestational diabetes, BMJ 314 (1997), 3-4.

In the UK two cases of cesareans against the women's will have entered court cases, BMJ 314 (1997), 8. Gestation can indicate the outlook for preterm babies, BMJ 314 (1997), 107-11. On preterm babies; JAMA 277 (1997), 126-32; and incubators, Lancet 348 (1996), 1719; NEJM 334 (1997), 230-1. Birth order is discussed in Science 275 (1997), 624-5. Children's living conditions can affect adult health, SSM 44 (1997), 13-24, 327-36. Brain development in infants is reviewed in Time (24 Feb 1997), 24-33. Pregnant women's brain size decreases around the time of birth, NS (11 Jan, 1997), 5. On baby milk and Nestle, BMJ 314 (1997), 167.

A new book is Patrick, Mark & Julie, The Tiniest Miracle. Angel of Grace (Avon Books, 1997; address Dept. FP., 1350 Ave of the Americas, New York, NY 10019, USA; ISBN 0-380-78442-4, 278pp., US$6). It describes the story that was discussed on the media widely at the time, of fetal surgery to remove a lung tumor, and the growth of their 5 year old daughter, who is now healthy. Fetal bone marrow transplants are now being considered, BMJ 314 (1997), 170.

There are some fetal abnormalities which are higher for young mothers than older mothers, including gastrochisis, porencephaly, septo-optic dysplasia, early body stalk disruptions and prenatal vascular disruptions, AJMG 69 (1997), 237-9. Methods to study demographics and infant mortality are explored in Health & Place 2 (1997), 229-38. More calls for folic acid tablets in pregnancy are in JAMA 277 (1997), 548-52, 884-5; Lancet 349 (1997), 735; and in life in general, Lancet 349 (1997), 780. A Swedish study found place of birth was associated with birth weight which confounds studies of the effects of birth weight on disease, J. Epid. & Comm. Health 51 (1997), 19-23. Also on birth weight, SSM 44 (1997), 1107-14. Chronic exposure to work can result in more preterm delivery, AJPH 87 (1997), 199-204. A Swedish study supports an association between maternal smoking and limb reduction malformations, AJPH 87 (1997), 29-32. Letters on birth when mothers take fluoxetine are in NEJM 336 (1997), 872-3; Lancet 349 (1997), 809.

On child raising across culture, Shants-Hopko, N. "Birth in the Japanese context", J. Obstetric, Gynecological and Neonatal Nursing 24 (1995), 343-51; Wang, JF. "Caregiver-child interactions in Japan, Taiwan and the United States", J. Obstetric, Gynecological and Neonatal Nursing 24 (1995), 353-61. A book review of Motherhood and Mental Health is JAMA 277 (1997), 1008-9. A critique of why babies should spend the night apart from parents is Time (14 April, 1997), 48-9.

Fetal-maternal conflicts and the case of Medea is discussed in JME 23 (1997), 19-25. Children's conflicts are discussed in a book review of Sulloway, FJ., Born to Rebel: Birth Order, Family Dynamics, and Creative Lives (NY: Pantheon Books, 1996, US$30) in NEJM 336 (1997), 968.

On home birth, BMJ 314 (1997), 678-9; and on maternity services, BMJ 314 (1997), 844. A UK Audit Commission report has said that routine pregnancies do not need obstetrician care, BMJ 314 (1997), 845; though a call for local maternity care is made in a US study, AJPH 87 (1997), 85+. Letters on use of opioids in labour are in Lancet 349 (1997), 726-8.

Women's autonomy in childbirth is debated in BMJ 314 (1997), 1143. Commentaries on caesarean section as a treatment for mental disorder, and the case "Tameside & Glossop Acute Services Unit v CH (a patient) [1966] 1 FLR 762" is discussed in BMJ 314 (1997), 1183-7. A new court case on caesareans for a women judged to be mentally incompetent to decide has been decided in the UK High Court on 26 March, finding that hospitals cannot force caesereans on competent women, BMJ 314 (1997), 624, 993; Reproductive Freedom News (18 April 1997), 7. Also on cesareans, Lancet 349 (1997), 666, 815; BME 126 (1997), 1.

There are some fetal abnormalities which are higher for young mothers than older mothers, including gastrochisis, porencephaly, septo-optic dysplasia, early body stalk disruptions and prenatal vascular disruptions, AJMG 69 (1997), 237-9. Methods to study demographics and infant mortality are explored in Health & Place 2 (1997), 229-38. More calls for folic acid tablets in pregnancy are in JAMA 277 (1997), 548-52, 884-5; Lancet 349 (1997), 735; and in life in general, Lancet 349 (1997), 780. A Swedish study found place of birth was associated with birth weight which confounds studies of the effects of birth weight on disease, J. Epid. & Comm. Health 51 (1997), 19-23. Also on birth weight, SSM 44 (1997), 1107-14. Chronic exposure to work can result in more preterm delivery, AJPH 87 (1997), 199-204. A Swedish study supports an association between maternal smoking and limb reduction malformations, AJPH 87 (1997), 29-32. Letters on birth when mothers take fluoxetine are in NEJM 336 (1997), 872-3; Lancet 349 (1997), 809.

On child raising across culture, Shants-Hopko, N. "Birth in the Japanese context", J. Obstetric, Gynecological and Neonatal Nursing 24 (1995), 343-51; Wang, JF. "Caregiver-child interactions in Japan, Taiwan and the United States", J. Obstetric, Gynecological and Neonatal Nursing 24 (1995), 353-61. A book review of Motherhood and Mental Health is JAMA 277 (1997), 1008-9. A critique of why babies should spend the night apart from parents is Time (14 April, 1997), 48-9.

Fetal-maternal conflicts and the case of Medea is discussed in JME 23 (1997), 19-25. Children's conflicts are discussed in a book review of Sulloway, FJ., Born to Rebel: Birth Order, Family Dynamics, and Creative Lives (NY: Pantheon Books, 1996, US$30) in NEJM 336 (1997), 968.

On home birth, BMJ 314 (1997), 678-9; and on maternity services, BMJ 314 (1997), 844. A UK Audit Commission report has said that routine pregnancies do not need obstetrician care, BMJ 314 (1997), 845; though a call for local maternity care is made in a US study, AJPH 87 (1997), 85+. Letters on use of opioids in labour are in Lancet 349 (1997), 726-8.

Women's autonomy in childbirth is debated in BMJ 314 (1997), 1143. Commentaries on caesarean section as a treatment for mental disorder, and the case "Tameside & Glossop Acute Services Unit v CH (a patient) [1966] 1 FLR 762" is discussed in BMJ 314 (1997), 1183-7. A new court case on caesareans for a women judged to be mentally incompetent to decide has been decided in the UK High Court on 26 March, finding that hospitals cannot force caesereans on competent women, BMJ 314 (1997), 624, 993; Reproductive Freedom News (18 April 1997), 7. Also on cesareans, Lancet 349 (1997), 666, 815; BME 126 (1997), 1.

Smoking is associated with lower birth weight in both obese and normal weight women, AJPH 87 (1997), 543-4, 591-6. Mothers who weighed less than 2000g at birth have a higher risk of losing their own babies, BMJ 314 (1997), 1376-80; see also Desai, M. & Hales, CN. "Role of fetal and infant growth in programming metabolism in later life", Biol. Rev. 72 (1997), 329-48. Sleeping position and parental smoking are confirmed as risk factors for sudden infant death syndrome in Scotland, BMJ 314 (1997), 1516-20. Social class is related to frequency of preterm birth, Lancet 349 (1997), 1040-1; AJPH 87 (1997), 597-603. Magnetic resonance imaging has been used on the brain of premature infants, Lancet 349 (1997), 1741.

Even if some pollutants can be found in breast milk such as PCBs, it is considered the best method of feeding, Lancet 349 (1997), 1525. A study has found no higher incidence of birth defects among Gulf War veterans, NEJM 336 (1997), 1650-6; and on occupational reproductive hazards, Lancet 349 (1997), 1385-8; AJOG 176 (1997), 826-32. Prenatal magnesium sulfate has a risk of cerebral palsy but that is being questioned, JAMA 277 (1997), 1033-4. Hair tests can be used to check if a woman is using cocaine, AJPH 87 (1997), 352-8.

A mouse model study that found strain differences in folate pathway genes in response to teratogens may be linked to teratogenic malformations, AJMG 70 (1997), 303-11. There are different forms of the enzymes, Lancet 349 (1997), 1591-3. Also on vitamins in pregnancy, AJMG 70 (1997), 206; 71 (1997), 93-6.

There is more risk of domestic violence after birth, BMJ 314 (1997), 1295; Brit. J. O&G 104 (1997), 528-31.
In general on the mother-fetus relationship, PNAS 94 (1997), 5998-6000; Flagler, E et al. "Bioethics for clinicians: 12. Ethical dilemmas that arise in the care of pregnant women: rethinking "maternal-fetal conflicts"", CMAJ 156 (1997), 1729-32.

A report on environmental estrogens has been withdrawn, Science 276 (1997), 1489+; 277 (1997), 462-3. Vitamin A has not been found to be linked to birth defects, AJOG 177 (197), 31-6. On fetal imaging and potential therapy in utero, NS (26 July 1997), 13.

Amniotic fluid infection is linked to cerebral palsy, JAMA 278 (1997), 247-8. Calcium supplements decrease incidence of preclampsia, JAMA 277 (1997), 1878-9. On prevention of neural tube defects, Lancet 350 (1997), 30-1. Behaviour of women during pregnancy also depends on culture, AJPH 87 (1997), 1022-6.

A book review of Williams, AS. Women and Childbirth in the Twentieth Century (Sutton 1997, ISBN 0-7509-1209-X, 331pp., 20pds) is Lancet 350 (1997), 301; and a paper on feminist theory, Sociol. Health & Illness 19 (1997), 348-58. Women can challenge a hospital in the UK over a forced cesarean, BMJ 315 (1997), 78. Social class and preterm birth are discussed in Lancet 350 (1997), 148. Newborns released home before 30 hours after birth are at increased risk of re-hospitalization during the first month of life, JAMA 278 (1997), 293-8. Inexpensive methods can be reduced to prevent perinatal infections, BMJ 315 (1997), 199-200. Child abuse is reportedly common in Ontario, Canada, JAMA 278 (1997), 131-5.

The New York Governor signed a ban (AB3379) on female genital mutilation on 29 Sept., 1997, Reproductive Freedom News (3 Oct. 1997), 6. A WHO/UNESCO/UNCF/UNPF statement condemning the practice has been released, also in BME 130 (1997), 4-5. A Charter for ethical research in maternity care is in BME 130 (1997), 8-11.

Calcium supplementation was not found to increase cardiac output, but it still lowers blood pressure in third trimester, O&G 90 (1997), 157-61; and it decreases the child's systolic blood pressure, BMJ 315 (1997), 281-5. On folic acid, Lancet 350 (1997), 664-5. High blood pressure in later age was not associated with low birth weight in a UK study, BMJ 315 (1997), 449-53; but it was associated with heart disease and stroke, BMJ 315 (1997), 396-400. Also starvation in the womb makes a person more susceptible to infections, NS (2 Aug. 1997), 4. On problems of diabetic mothers, BMJ 315 (1997), 263-4. Woman's choice of partner can influence sex of the child, NS (27 Sept. 1997), 11.

The environment in a mother's womb has a stronger effect on a baby's intelligence then previously thought, and may account for some of the strong genetic associations seen for identical twins, Lancet 350 (1997), 342; Nature 388 (1997), 468-71; NS (2 Aug. 1997), 3; Science 277 (1997), 641. Cognitive function is associated with birth weight, BMJ 315 (1997), 401-3. Girls exposed to pesticides in the womb, that mimic estrogen, go through puberty earlier and are more likely to develop breast cancer, NS (2 Aug. 1997), 5. On estrogen receptor roles, Science 277 (1997), 1439. Pregnancy after treatment for breast cancer was not associated with bad outcome in a Danish study of 5725 women, Lancet 350 (1997), 319-22.

Letters on enforced cesareans are in BMJ 315 (1997), 488; and on repeat ones, O&G 90 (1997), 312-5; BMJ 315 (1997), 615. Middle aged mothers tend to live longer, Nature 389 (1997), 133. Bab rats given more maternal care exhibit less stress, Science 277 (1997), 1659-62, 1620-1. Intelligence is an important determinant of child survival, Sandiford, P. et al. "Does intelligence account for the link between maternal literacy and child survival?", SSM 45 (1997), 1231-9. Home visits for prenatal care helps pregnant mothers, JAMA 278 (1997), 637-43, 680-1. Results of a US adolescent study are in JAMA 278 (1997), 823-32, 864-5. In the US the obstetrical care of newborns of some immigrants is withheld with bad consequences for those mothers and babies, NEJM 337 (1997), 705-7.

Cocaine causes subtle damage on fetal brains as they develop, Science 278 (1997), 38-9. A report of a rare disorder, coanal atresia and hypothesis following methimazole exposure in utero is AJMG 75 (1998), 220-2. Topical use of tretinoin does not appear to cause any birth defects, Lancet 350 (1997), 1143. Mercury levels need to be reduced to prevent damage before birth, NS (22 Nov 1997), 4. The South Carolina Supreme Court reaffirmed a conviction for bad behaviour as a pregnant mother to the fetus, Reproductive Freedom News (31 Oct 1997), 5 (see above). On 31 Oct, 1997, the Canadian Supreme Court voted to support that a fetus cannot be legally treated as an individual separate from its mother, so that the government cannot force a woman into a drug treatment program to protect the health of the fetus, Reproductive Freedom News (1 Dec 1997), 8; CMAJ 157 (1997), 1586-7. It is unlikely fetuses feel pain until after 26 weeks, and on fetal suffering, NS (1 Dec 1997), 13.

There are some high prevalence areas (6 per 1000) for neural tube defects (NTDs), for example one in Northern provinces in China, AJMG 73 (1997), 113-8. A dose of 400ug of folic acid should protect against NTDs, Lancet 350 (1997), 1642-3, 1666-9; 1322-4; JAMA 278 (1997), 892-3. There appears to be a genetic risk factor for unexplained recurrent early pregnancy loss, Lancet 350 (1997), 861. There may only be minor if any affects of paternal age on XY aneuploidy, Cytogenet Cell Genet. 78 (1997), 116-9. Giving birth in the 40s may increase life expectancy, Nature 390 (1997), 922. On origins of polcystic ovaries in fetal life, Lancet 350 (1997), 1131-5. Prenatal stress affects suckling calves, J. Animal Science 75 (1997), 3143-51. Birth weight and life expectancy are inversely related, BMJ 315 (1997), 825-6, 1189-93, 1342-9; and on racial comparisons, NEJM 337 (1997), 1209-14, 1232-3. Decline in social status and a low birth weight baby are risk factors for a future low birth baby in a Danish study, BMJ 315 (1997), 1498-502. Scottish birth weights are increasing, BMJ 315 (1997), 1205. Weight is linked in a complex way to later heart disease, BMJ 315 (1997), 837-40. Some of these problems are also seen in health of adopted children from Eastern Europe, JAMA 278 (1997), 922-4.

There has been wide coverage of the live birth of septuplets to the US McCaughey couple, raising ethical issues on the risks of multiple pregnancies and selective termination of some to increase chances of health in the survivors, Time (1 Dec 1997), 42-7; see an opinion by J. Fleming in Bioethics Research Notes 9 (Dec 1997), 37-8. A review of care is Morrison, JJ. & Rennie, JM. "Clinical, scientific and ethical aspects of fetal and neonatal care at extremely preterm periods of gestation", Brit. J. O&G 104 (1997), 1341-50. On applying human factor methods to clinical risk, Brit. J.O&G 104 (1997), 1225-32. In a Tennessee study, Medicare coverage extension to prenatal care increased its use but did not reduce likelihood of preterm birth, Amer. J. Preventive Medicine 13 (1997), 292-7.

A paper on when to induce labour is, Gafni A. et al. "Induction of labour versus expectant management for prelabour rupture of the membranes at term: an economic evaluation", CMAJ 157 (1997), 1519-25. Induction with oxytocin (IwO) was cheaper, however induction with prostaglandin (IwP), was not so different so they recommend choices to the mothers, given no clinical differences. On analgesia for labour, NEJM 337 (1997), 1764-6. Letters on early discharge of newborns are in JAMA 278 (1997), 2064-6. The American Academy of Pediatrics recommends mothers to breast feed for one year, BMJ 315 (1997), 1487. On women's health, BMJ 315 (1997), 1154-7, 1227-30. A letter on an emotional story on cesareans for mentally ill women is BMJ 315 (1997), 1017.

A book review of The Dilemma of Ritual Abuse is JAMA 278 (1997), 1709-10. Hidden video cameras in UK hospitals have found child abuse, BMJ 315 (1997), 1111. A study of rodent brains is being made to examine why women may reject their babies, NS (13 Dec 1997), 4.

A study of workplace effects on semen quality is F&S 69 (1998), 11-8. Acute famine in utero does not appear to affect women's reproductive fertility, AJPH 87 (1997), 1962-6; however it reduces glucose tolerance, Lancet 351 (1998), 173-7. On intrauterine growth and race, AJPH 87 (1997), 1977-83; and maternal weight, AJPH 87 (1997), 1984-8; NEJM 338 (1998), 147-52, 191-2; and preventing nausea and vomiting in pregnancy, O&G 91 (1998), 149-55. Preventing preterm birth is discussed in NEJM 338 (1998), 55-6; NS (31 Jan. 1998), 10, 24-8. Too much light and noise can disturb premature babies development, Lancet 350 (1997), 1826. Papers discussing neonatal vitamin K administration and childhood cancer are in BMJ 316 (1998), 161-2, 173-7, 178-84, 184-9, 189-93.

Caesareans are discussed in Lancet 351 (1998), 155. A paper looking at the evolution of maternal instinct is Hawkes, K. et al. "Grandmothering, menopause, and the evolution of human life histories", PNAS 95 (1998), 1336-9. Early discharge from hospital can be associated with maternal depression, MJA 167 (1997), 244-7. On motherhood and mental health, Lancet 351 (1998), 378. The mechanism of folic acid in reducing birth defects is discussed in Lancet 351 (1998), 450. Folic acid also reduces heart disease, JAMA 279 (1998), 359-64, 392-3.

On 29 December, 1997, the Supreme Administrative Court of Egypt upheld a Health Ministry decision banning government-certified doctors and health workers from performing female genital mutilation, with a 3 year possible prison term; Reproductive Freedom News (22 Jan 1998), 5-6; Lancet 351 (1998), 120.

Uses of quilts by babies is associated with increased rate of sudden infant death syndrome when babies are in suipine or on the side, but not in the at risk position, BMJ 316 (1998), 195; and on the genetics of it, NatMed 4 (1998), 157-8. Childhood depression is one of the consequences of childhood sexual abuse, BMJ 316 (1998), 198-201; MJA 167 (1997), 238-9.

On HLA genes in pregnancy, AJHG 62 (1998), 1-5. On folic acid, Amer.J.Clin. Nutrition 66 (1997), 1299-300; Lancet 351 (1998), 834-5; CMAJ 158 (1998), 773-4; and it may be tried for heart disease prevention as well, AJPH 88 (1998), 61-7. A review from the USA is Chavkin, W. et al. "National survey of the States: Policies and practices regarding drug-using pregnant women", AJPH 88 (1998), 117-9. Some selective serotonin reuptake inhibitors do not appear to cause increased teratogenic risk in recommended doses, JAMA 279 (1998), 609-10. Routine antenatal varicella screening is said not to be cost effective in O&G 91 (1998), 519-28. On parental education in Nepal, BMJ 316 (1998), 805-11.

Healthy pregnant women can undergo training without affecting the fetus, Amer. J.O&G. 178 (1998), 280-6. On abuse during pregnancy, AJPH 88 (1998), 185-7, 274-6; O&G 91 (1998), 511-4; and Ireland may have mandatory reporting, Lancet 351 (1998), 507. The UK maternity statistics have been released, BMJ 316 (1998), 566-7. They show cesarean rates in 1995 at 15%, up from 11% in 1989. On risk factors for preterm birth in New Zealand, NZMJ 111 (1998), 14-6; and in general, AJPH 88 (1998), 183-4. Low birth weight may be associated with higher maternal blood pressure, BMJ 316 (1998), 834-7. Fetal life in turn alters adult heart disease risk, SSM 46 (1998), 683-93. A study of oxygen saturation in infants under 15% oxygen is BMJ 316 (1998), 887-94. Trends and variations in length of hospital stay for childbirth in Canada are reported in CMAJ 158 (1998), 875-80. Safe motherhood can make a difference, CMAJ 158 (1998), 889-94.

Some precautions have been issued in the UK on recovered memories of childhood sexual abuse, BMJ 316 (1998), 488-9. High mountain trekking holidays should be avoided for very young children, BMJ 316 (1998), 874-5. There is increased auditory cortical representation in musicians, Nature 392 (1998), 811-4. There has been criticism of a trial using an possible anti-aggression drug, Nature 392 (1998), 747.

Women have been urged to avoid eating peanuts during pregnancy and lactation, BMJ 316 (1998), 1926. There may be a risk of fetal anomalies from selective serotonin reuptake inhibitors, JAMA 279 (1998), 1873-4. Pregnant women with epilepsy face a dilemma when to stop their medication, which influences the fetus, NS (9 May 1998), 12. Thiamine fortification of food to avoid Wernicke's encephalopathy is suggested in MJA 168 (1998), 534-5. More on folic acid supplements, O&G 91 (1998), 1027-34. Prenatal famine influences later health, Lancet 351 (1998), 1360-2.

On the variation in attendance of deliveries by skilled personnel, Br. J. O&G 105 (1998), 375-6. Maternal education affects infant mortality, and this can magnify racial differences, AJPH 88 (1998), 651-6. A comparison of fetal and maternal factors linked to pre-eclampsia is BMJ 316 (1998), 1343-7. Small fetuses are at high risk, BMJ 316 (1998), 1483-7; and father's stature influences the fetal weight, AJO&G 178 (1998), 1022-6. The fetus that is the first birth has a higher cortisol level than subsequent ones, NS (2 May 1998), 11. Fetal loss and grief are discussed in NEJM 337 (1998), 1552-3. Prolongation of the QT interval is linked to Sudden Infant Death Syndrome, NEJM 337 (1998), 1709-14, 60-1. Mortality in neonatal intensive care units is discussed in BMJ 316 (1998), 1931-5. It is not always easy to gather birth data, BMJ 316 (1998), 1710-1.

Health promotion for children is discussed in AJPH 88 (1998), 869-71. Violations on the international marketing code of breast milk substitutes in Bangladesh, Poland, South Africa and Thailand are reported in BMJ 316 (1998), 1117-22. Companies in 31 countries break the code, BMJ 316 (1998), 1103-4, 1115; 1548-9. A call for doctors to encourage better parenting is BMJ 316 (1998), 1545. Caretakers in primate species live longer, PNAS 95 (1998), 6866-9. There are ethical issues in immigration reporting laws, AJPH 88 (1998), 967-8.

The mechanism of folic acid prevention of neural tube defects is discussed in NatMed 4 (1998), 895-6; MJA 169 (1998), 182-3; NEJM 339 (1998), 475-7. The American College of Medical genetics Statement on Folic Acid, supporting its use is AJMG 78 (1998), 381. Fetuses metabolize a product of tobacco, nicotine-derived nitrosaminoketone, AP (24 August 1998). Smoking cessation does help the fetus better develop, O&G 92 (1998), 201-5; but if smoking continues it has permanent effects on maternal lung, Lancet 352 (1998), 453. Children from fathers who were exposed to radiation may be more vulnerable to carcinogens, NS (1 August 1998), 20; BMJ 317 (1998), 299. On alcohol consumption by pregnant women in USA, O&G 92 (1998), 187-92. Fetal alcohol syndrome is common in South Africa, Lancet 352 (1998), 295. On diabetes in pregnancy, MJA 169 (1998), 68-9. Prenatal care of cocaine-exposed babies can increase their chance of a healthy life, O&G 92 (1998), 193-200. Diethylstilbestrol exposed daughters show no increased cancer risk except for clear cell adenocarcinoma, JAMA 280 (1998), 630-4.

A paper calling for the age of legal viability to be 24 weeks is Monash Bioethics Review 17 (July 1998), 30-3; J. Perinatal Medicine 25 (1997), 418-20. The increased reporting of births under 500g has masked the improvements in neonate care, AJPH 88 (1998), 1236-9. Mutations in glucokinase gene result in reduced birth weight, NatGen 19 (1998), 268-70. On maternal weight gain in pregnancy, AJPH 88 (1998), 1168-74. A survey finding wide opinion is Norup, M. "Limits of neonatal treatment: a survey of attitudes in the Danish population", JME 24 (1998), 200-5. In general on prenatal care, JAMA 279 (1998), 1623-8, 1661-2; Brit. J. OG 104 (1998), 873-5. Zinc supplements can improve children's health in impoverished areas, BMJ 317 (1998), 369.

The medicalization of pregnancy is discussed in SSM 47 (1998), 1067-76. A study suggesting that women in labour should not walk unaccompanied is NEJM 339 (1998), 117-8. A discussion of elective cesareans upon request is BMJ 317 (1998), 462-5. Individual efforts to lower rates are studied in AJOG 178 (1998), 1207-14. Australian home births have a higher death rate than hospital ones, BMJ 317 (1998), 384-8. Some sudden infant deaths are linked to odd heartbeat, NEJM 338 (1998), 1709-14; Science News 153 (1998), 372; Lancet 351 (1998), 1865; but many are caused by bad sleep position, JAMA 280 (1998), 329-35, 336-40, 341-6. A call for part-time work to allow better breast feeding is AJPH 88 (1998), 1042-6. The UN has amended breast feeding policy to recommend all HIV infected mothers be told of the risks, BMJ 317 (1998), 297. On marketing of substitutes, BMJ 317 (1998), 350-1.

Late-talking infants may have genetic factors contributing to this, NatMed 4 (1998), 892-3; Nature Neuroscience 1 (1998), 324-8; NS (1 August 1998), 12. On attention deficit hyperactivity disorder, Science 281 (1998), 1149-50; SA (Sept. 1998), 66-71. Babies may cry for attention in order to make their parents patient, and select patient parents, NS (22 August 1998), 11. Child abuse is discussed in BMJ 317 (1998), 484-5; and neonaticide, BMJ 317 (1998), 356. There are monkey models of human child abuse, Science News 153 (1998), 324; Psychological Bulletin (May 1998). The question when to start modifying heart disease risk factors is discussed in JAMA 279 (1998), 1261-2. Impaired fetal growth is a risk factor also, Lancet 352 (1998), 173-8; BMJ 317 (1998), 241-5.

On maternal nutrition, pregnancy outcome and public health policy, CMAJ 159 (1998), 669-70. In general on maternity care, BMJ 317 (1998), 1027-8; JAMA 280 (1998), 1271-3; NS (3 Oct. 1998), 16; O&G 92 (1998), 842-8. Fetal exposure to maternal cortisol is reported in Lancet 352 (1998), 707-8. No impact of benzodiazepines and major malformations of the fetus was detected in a Canadian study, BMJ 317 (1998), 839-43. Malarial susceptibility to malaria may be prevented by an anti-adhesion vaccine, Lancet 352 (1998), 1447. Internet information is reviewed in Lancet 352 (1998), 916; and book review of a biography of Dr. Spock is Lancet 352 (1998), 825-6. Most of the black/white birth rate differences can be explained by other factors, O&G 92 (1998), 814-22. Also on the birth weight, O&G 92 (1998), 769-74. A review of the continuing legacy of third generation chemical mutations in Vietnam from Agent Orange is NS (3 Oct. 1998), 18-9.

A commentary is Bridges, RS. "The genetics of motherhood", NatGen 20 (1998), 108-9. A paper identifying genetic mutations is Finette, BA. et al. "Gene mutations with characteristic deletions in cord blood T lymphocytes associated with passive maternal exposure to tobacco smoke", NatMed 4 (1998), 1144-51; and on smoking trends, BMJ 317 (1998), 728. This could be due to carcinogen transfer, like NNK, BMJ 317 (1998), 555; Science News 154 (1998), 133. Immunosuppression mediated by IDO, an enzyme that catalyses tryptophan, may prevent rejection of the fetus by the maternal immune system, NatMed 4 (1998), 1128-9; NS (10 Oct. 1998), 12.

Better techniques to examine whether babies need oxygen at birth are discussed in NS (19 Sept. 1998), 24. A review of numerous species is Ebensperger, LA. "Strategies and counter strategies to infanticide in mammals", Biol. Reviews 73 (1998), 321-46. The Japanese supreme court have had to consider how to educate clients, to lower the rate of abortions, BMJ 317 (19981), 041-6. See also NEJM 339 (1998), 1211-6, 1239-41. Letters on the shaken baby syndrome are in NEJM 339 (1998), 1329-30.

Long-chain polyunsaturated fatty acids in milk supplements may help infant problem solving, Lancet 352 (1998), 688-91.

In the UK a pregnant woman has a right to refuse medical treatment, Dispatches 9 (No. 1, Autumn 1998), 8-12. A Mexican study showing that psychosocial support during labour and childbirth increased breast feeding and decreased time in labour is Brit. J.O&G 105 (1998), 1056-63. Washington and Colorado state programs for Medicaid prenatal services improved birth outcomes, AJPH 88 (1998), 1623-9. Attempts to identify at risk mothers for preterm birth or pre-eclampsia have not succeeded, Lancet 352 (1998), 1875-6; siv22; NEJM 339 (1998), 1434-9, 1858-60. The use of maternal plasma fetal DNA as a marker for preterm labour is suggested in Lancet 352 (1998), 1904-5. Suboptimal first trimester growth may be associated with low birth weight, NEJM 339 (1998), 1817-22. Prediction of need for cesareans is better however, O&G 92 (1998), 935-9. Maternal mortality is discussed in BMJ 317 (1998), 1431-2.

Drug treatment during pregnancy is reviewed in BMJ 317 (1998), 1503-6. On the mechanism of action on the fetus of diethylstilbestrol, NatGen 20 (1998), 228-30. Exposure to smoke leads to fetal DNA mutations, Science News 154 (1998), 213. In utero fetal surgery is reported in Adzick, NS. et al. "Successful fetal surgery for spina bifida", Lancet 352 (1998), 1675-6; BMJ 317 (1998), 1474. A small transmitter can be implanted into the womb after surgery to check if the fetus is doing OK, and warn if premature labour begins, NS (28 Nov. 1998), 17. Risk factors for neural tube defects include lower socioeconomic status in the USA, AJPH 88 (1998), 1674-80. The question of whether too much ultrasonography causes harm is discussed in Lancet 352 (1998), 1568-9. Molecular analysis of the maternal plasma can determine fetal RhD status, NEJM 339 (1998), 1734-8, 1775-7. In general on obstetrics and clinical trials, Lancet 352 (1998), 1988-9.

The decision to treat infants of low birth weight is associated with risks of mental and physical health problems, Wang ST. et al. "Neurodevelopment of surviving infants at age two years, with a birthweight less than 2000g and cared for in neonatal intensive care units (NICU) - results from a population based longitudinal study in Taiwan", Public Health 112 (1998), 331-6. The problem may be suboptimal neonatal nutrition as the brain forms, BMJ 317 (1998), 1481-7. Breast milk and substitutes, and milk in later life, are discussed in Lancet 352 (1998), 1703-4; BMJ 317 (1998), 1385-6, 1407. Neonatal encephalopathies are discussed in BMJ 317 (1998), 1537-8.

A book review of Mousseau, TA. & Fox, CW., eds., Maternal Effects as Adaptions (Oxford University Press, 1998, 348pp., US$65) is Nature 397 (1999), 36; and on paternal love, NS (12 Dec. 1998), 38-41. Natural childbirth could be important in brain development, NS (21 Nov. 1998), 24. Minimizing the pain and discomfort to babies during infant stages reduces risk of suicide in later life, Jacobson, B. & Bygdeman, M. "Obstetric care and proneness of offspring to suicide as adults: case-control study", BMJ 317 (1998), 1346-9. The question of whether short stature or achondroplasia is due to neglect is in Lancet 352 (1998), 1950-1. On sexual abuse of boys, JAMA 280 (1998), 1855-62, 1864-5; and on female genital mutilation, MJA 169 (1998), 455-6. A statement on the need for sports activity by children is Bulletin WHO 76 (1998), 445-7. Discussion of whether orphanages are useful is in Amer. J. Psychiatry 155 (1998), 1307-8; Science News 154 (1998), 230. Other children could be very important in child's development not only parents, NS (12 Dec. 1998), 48-51. On child care in insects, SA (Jan. 1999), 72-7. Spending too long in bed may be related to increased mortality, BMJ 317 (1998), 1675-7.

A growing number of infanticides in Hungary have forced the government to introduce stiffer penalty, to a mandatory imprisonment of 2-8 years, Lancet 353 (1999), 570. On legal issues in fetal injury at late stage, Modern Law Review 62 (1999), 128-32. A study of 260865 twin babies found an excess of genetic malformations as compared with singleton babies, Mastroiacovo, P. et al. "Congenital malformations in twins: An international study", AJMG 83 (1999), 117-24. Results of a study of the effects of gestational diabetes on genetic mutations is AJMG 83 (1999), 402-8.

A Norwegian study of 2161 babies born 1979-81 found that fetuses exposed to ultrasound were 30% more likely to develop left-handed, What Doctors Don't Tell You 98 (No. 4 1998), 5. Occupational exposure to organic solvents can affect the fetus, JAMA 281 (1999), 1106-9; Lancet 353 (1999), 1071. Folic acid is discussed in Lancet 353 (1999), 1187. On prenatal care, FDA Consumer (March 1999), 18-21; AJPH 89 (1999), 480-2. On risk of diabetic pregnancies, Science News 154 (1998), 356.

The ethics and law or protecting fetuses from certain harm are discussed in Politics & the Life Sciences 17 (1998), 113-8. A Canadian survey is physical abuse during pregnancy, prevalence and risk factors, CMAJ 160 (1999), 1007-11. A hormone found in the placenta seems to control the timing of birth, a review is SA (March 1999), 68-75. Fetal surgery for spina bifida is discussed in Lancet 353 (1999), 406-7. A study of why drugs may affect developing brains is Lancet 353 (1999), 126; BMJ 318 (1999), 433-4. Sex ratio was not altered in families exposed to PCBs in Taiwan, unlike Italy, Lancet 353 (1999), 206-7. Cocaine use and smoking increase risk of spontaneous abortion, NEJM 340 (1999), 333-9, 380-1.

A book review on Comfort Women of World War II is Lancet 353 (1999), 1195-6. A study of the place of birth is BMJ 318 (1999), 721-3. On evolution of cesarean sections and choices to have one, Brit. JOG 106(1999), 213-20, 286-7.

The question whether to work or not is discussed in AJPH 89 (1999), 477-9. Papers on mortality of babies of lone mothers are BMJ 318 (1999), 908-12, 912-4. A European study suggests mothers are active determinants of breast-feeding frequency, Lancet 353 (1999), 1152. The Advertising Standards Authority has upheld a complaint against Nestle for its marketing of infant formula in developing countries, BMJ 318 (1999), 417. On nurture, JAMA 281 (1999), 763-4. Smoking mothers tend to have smaller fetuses, BMJ 318 (1999), 885-6, 897-900. There is need for further analysis of benefits of routine neonatal examinations, BMJ 318 (1999), 619-20; Lancet 353 (1999), 343. Antibiotics may not help premature babies from infection, BMJ 318 (1999), 548-9. A comment on why the Japanese MHW waited for several years until its own cot death study before advising parents not to smoke or not to put babies on their stomachs, NS (13 March 1999), 58. On attention deficit hyperactivity disorder, Science News 154 (1998), 343. A book review of Harris, CR. The Nurture Assumption: Why Children Turn Out the Way they Do (Bloomsbury/Free Press 1998, 462pp.) is Nature 398 (1999), 675-7.

On the use of folic acid in the USA, JAMA 281 (1999), 1883-4. The effect of folic acid fortification of food upon plasma folate in adults is positive, NEJM 340 (1999), 1449-54. Alcohol-related risks of breast cancer can be reduced by folate, JAMA 281 (1999), 1632-7. Fetal growth rate is discussed in Lancet 353 (1999), 1460. Prothrombotic mutations may be a risk factor for preterm birth, Lancet 353 (1999), 1411-2.

Pregnancy discrimination is discussed in Modern Law Review 62 (1999), 435-47; and safe motherhood in Bulletin WHO 77 (1999), 399-406. A program to allow pregnant mothers with phenylketonuria to seek advice from others with experience benefits the outcome of pregnancy, AJPH 89 (1999), 762-4. The semiconductor industry is associated with toxic chemicals, some of which are now blamed for birth defects, NS (15 May 1999), 18-9. A paper on the mother-to-child transmission of toxoplasmosis is Lancet 353 (1999), 1829-33.

On infant learning, Science 284 (1999), 434-7; Science News 155 (1999), 184-6. Preterm babies have increased chance of abnormal MRI brain scans, not only neurocognitive problems, Lancet 353 (1999), 1653-7. Low birthweight is also associated with diabetes, Lancet 353 (1999), 1789-92. Two paternal genes, Mest and Peg3 may alter a daughter's maternal instincts, NS (17 April 1999), 17. On rights in law for children, Modern Law Review 62 (1999), 350-70.

The effects of herbs on sperm DNA are discussed in F&S 72 (1999), 378-81. A review is Goldberg, JM. & Falcome, T. "Effect of diethylstilbestrol on reproductive function", F&S 72 (1999), 1-7. Infant growth after in utero exposure to zidovudine (se also AIDS section), is discussed in JAMA 282 (1999), 527-8. The safety of antidepressant use in pregnant women is discussed in JAMA 282 (1999), 222-3. DDT may be harmful for male fetuses, NS (26 June 1999), 15. On the fetal origins of adult disease, BMJ 319 (1999), 245-9. The effect of birthplace on breast cancers in Asian American women is thought to be negligible, but rather Asian American women use screening less, AJPH 89 (1999), 1248-52. Pregnancy does not increase mortality from breast cancer, BMJ 318 (1999), 1577; Cancer 85 (1999), 2424-32, 2301-5. On oxidative DNA damage, NatMed 5 (1998), 715. Stress should be avoided in all phases of life, NS (27 Feb. 1999), 26-31. Maternal nutrition affects are reviewed in BMJ 319 (1999), 339-43. The impact of a mass media campaign to take folic acid is discussed in BMJ 319 (1999), 291-2; and on the fall in births from spina bifida, BMJ 319 (1999), 92-3. Income also affects pregnancy, AJPH 89 (1999), 868-74; as does wartime famine, JAMA 282 (1999), 455-62, 479-81. On the assessment of prenatal abuse, AJPH 89 (1999), 1217-22. On maternal phenylketonuria, MJA 170 (1999), 592-5. The reasons why preterm infants die are surveyed in MJA 170 (1999), 528-32; and in Aboriginal communities in Canada, SSM 48 (1999), 1821-32. Survival can be at high cost to quality of life, Lancet 354 (1999), 4-5, 354-5. Predictors of low birthweight are reviewed in Brit.J.O&G 106 (1999), 834-41. Earlier discharge for newborns may increase health risks, BMJ 319 (1999), 469. On fetal surgery, JAMA 282 (1999), 287. Incubators placed in a Hungarian hospital have allowed babies to be abandoned more safely, BMJ 319 (1999), 214.The rights of pregnant women to refuse blood transfusions if Jehovah's Witness is discussed in JLME 27 (1999), 171-193. About 4000 children a year are born in water in the UK and the procedure has the same risks as normal, BMJ 319 (1999), 483-7, 524. Women's decisions about cesareans are discussed in MJA 170 (1999), 580-3; NEJM 341 (1999), 53-5. Psychological support in labour is needed, Brit.J.O&G 106 (1999), 617-9; BMJ 319 (1999), 381. Depression following earlier stillbirth is discussed in BMJ 319 (1999), 1721-4. On hormone replacement therapy, SSM 49 (1999), 469-81; JAMA 281 (1999), 2091-7, 2140-1; BMJ 318 (1999), 1645.

Despite a higher incidence of the C677T mutation in MTHFR in Ashkenazi Jews, which is a risk factor for spina bifida, they have a lower incidence, AJMG 86 (1999), 380-4. This may be linked to diet. On the apparent lability of neural tube closure in laboratory animals and humans see AJMG 87 (1999), 143-62; AJPH 89 (1999), 1637-40. Folic acid supplements of 400 micrograms a day reduced the rate of neural tube defects in a Chinese study, NEJM 341 (1999), 1485-90, 1509-19, 1546. Actually in the UK there has not been a decrease since the early 1990s, Lancet 354 (1999), 998-9. It could be because women were already aware of it before 1990. On serum folate levels and folic acid fortification of food, Lancet 354 (1999), 915, NEJM 341 (1999), 922-4. Detection of neural tube defects by ultrasound is reported in O&G 94 (1999), 562-6. Sex ratio is discussed in F&S 72 (1999), 751-2; BMJ 319 (1999), 548-9.

Information can result in stress, and a study is Yu, MS. Et al. "Impact of maternal parenting stress of receipt of genetic information regarding risk of diabetes in newborn infants", AJMG 86 (1999), 219-26. A study of psychological distress a year after birth in Italy and France is SSM 49 (1999), 1651-61. On the risk of violent death during pregnancy, Lancet 354 (1999), 1448. Children adopted late tend to have IQ increases, Science News 156 (1999), 54-5. On overseas adoptions, Far Eastern Economic Review (21 Oct. 1999), 50-1; NEJM 341 (1999), 1539-40. Children raised by single parents tend to do as well as children in other families, NS (16 Oct. 1999), 25. A book review on maternal behaviour is Nature 402 (1999), 120-1.

The ethics of maternal care provision are discussed in Otago Bioethics Report 8 (Oct. 1999), 1-18. Smoking in pregnancy is discussed in Lancet 354 (1999), 1390; AJPH 89 (1999), 1377-83; NEJM 341 (1999), 943-8. Air freshners may make pregnant women sick, NS (4 Sept. 1999), 17. Organic solvent abuse during pregnancy is linked to malformations, JAMA 282 (1999), 1033; as is ecstasy exposure, Lancet 354 (1999), 1441. Pregnant health care workers who give chemotherapy drips tend to have more miscarriages, NS (28 Aug. 1999), 16. Perinatal exposure to antiretrovirals is linked to persistent mitochondrial dysfunction, Lancet 354 (1999), 1046-7, 1084-9. Prenatal orgin of leukemia is reported in Lancet 354 (1999), 1486, 1499-503. The question of hypothyroidism screening is in Lancet 354 (1999), 1224-5. A chart looking at rates of survival for preterm babies can help decision-making in treatment decisions, BMJ 319 (1999), 1093-7. The rate of sudden infant death syndrome has dropped in the past decade, MJA 171 (1999), 411-3; BMJ 319 (1999), 697-700. A South African study found half the maternal deaths in 1998 could have been avoided, Lancet 354 (1999), 1536. A study on maternal mortality before and after reunification is BMJ 319 (1999), 1104-5. Motherhood improves learning and memory, Nature 402 (1999), 137.

Only a minor part of cerebral palsy cases begin in labour, BMJ 319 (1999), 1016-7. If breast feeding continues for at least 4 months after birth the risk of asthma is reduced, BMJ 319 (1999), 315-9. A WHO study on pregnancy during breast feeding is F&S 72 (1999), 431-40. Girls who have a good relationship with their father tend to enter puberty later, NS (2 Oct. 1999), 14. Spain is giving free health care to all pregnant women, regardless of their legal status, Lancet 354 (1999), 1368. On WHO plans for safe motherhood, Lancet 354 (1999), 940-3. Attitudes of Canadian women toward birthing centres and midwife care for childbirth are in CMAJ 161 (1999), 708-8. Slapping and spanking in childhood is associated with lifetime prevalence of psychiatric disorders, 805-9, 821-2.

Folic acid is still not being taken by many in the USA who would most benefit from it, Probe VIII (1 Jan. 2000), 6-7; also Lancet 354 (1999), 2167-8; BMJ 319 (1999), 1499. However babies are more healthy in the USA now than a decade ago, JAMA 282 (1999), 1807-10. The question whether fetal surgery is best for spina bifida fetuses is discussed in Lancet 354 (1999), 1795; JAMA 282 (1999), 1819-25, 1826, 1873-4.

Risks of alcohol inducing miscarriage are discussed in NS (20 Nov. 1999), 17. Moderate coffee consumption is unlikely to lead to risk of spontaneous abortion, but excess may, NEJM 341 (1999), 1639-44; BMJ 319 (1999), 1456. The affect of inhaled nitric oxide in neonates is discussed in Lancet 354 (1999), 2162-3. Preconceptional paternal exposure to pesticides increases the risk of childhood leukemia, Lancet 354 (1999), 1819. Poor growth in utero is linked to risk of coronary heart disease, BMJ 319 (1999), 1403-7. Work and pregnancy and fatigue are discussed in AJOG 181 (1999), 1172-9.

On laws governing pregnancy, Levman N. "Fostering relationships: the state and pregnancy", J Law and Social Policy 14 (1999), 217-42; Randall M. "Pregnant embodiment and women's autonomy rights in law: an analysis of the language and politics of Winnipeg Child and Family Services v. D.F.G. Saskatchewan Law Rev 62 (1999), 515-42. On pregnancy and an attractive body, BMJ 319 (1999), 1401-2. The terminology for fetus and mother are discussed in Brit. J. O.&G. 106 (1999), 1235-7.

On breast feeding and obesity, BMJ 319 (1999), 1576. WHO's recommendations to continue breast feeding until two years are supported by a study in Africa in Lancet 354 (1999), 2041-5. There is a lack of evidence of benefits from adding long chain polyunsaturated fatty acid to infant formula milk, Lancet 354 (1999), 1919, 1948-54. A comparison of infant mortality rate and GNP is Lancet 354 (1999), 2047. Vitamin A supplements are discussed in NEJM 341 (1999), 1697. Why babies cry is still largely unknown, BMJ 319 (1999), 1381. Bed-sharing with infants is risky before 4 months, and on sofas, but otherwise is not a risk factor for parents who do not smoke, BMJ 319 (1999), 1457-62.

Morning sickness and sex of child are discussed in Lancet 354 (1999), 2053; NS (18 Dec. 1999), 25. A case with a court-ordered cesarean is discussed in Nursing Ethics 6 (1999), 494-505. There is an increasing rate of unnecessary cesereans in richer Latin American countries, BMJ 319 (1999), 1397. The risks of birth injury while using vacuum assisted delivery devices is discussed in NEJM 341 (1999), 1758-9. Programming of fetal blood pressure in twins is reported in BMJ 319 (1999), 1313-4, 1325-9, 1330-3, Maternal thyroid deficiency may adversely affect neuropsychological development of the child, NEJM 341 (1999), 2015-7.

A study of the pregnancies by dead mothers is Paige, R. "Post-mortem pregnancies: a legal analysis", Dispatches 9 (No. 3, January 2000), 2-5. Management of inter-sexed newborns and consent is discussed in Purves, BS. "Parental consent and the surgical management of inter-sexed newborns", Monash Bioethics Review 19 (January 2000), 23-43. The use of vitality of newborns as a measure to decide if they undergo treatment is discussed in Nursing Ethics 7 (2000), 141-7. Ethics of intensive neonatal care is discussed in Lancet 355 (2000), 79. The effect of Medicaid managed care on pregnancy complications was found to be insignificant, O&G 95 (2000), 6-13. There is some variation in stress response to vaccination depending on method of delivery, Lancet 355 (2000), 120. Letters on the control of labour are in NEJM 341 (1999), 2098-9.

On 1 December, 1999, the Center for Reproductive Law and Policy asked the US Supreme Court to review a case of unauthorized urine-testing of 10 pregnant women for cocaine in South Carolina, Reproductive Freedom News 9 (Jan. 2000), 1, 4. Embryos can be attacked by mothers immune system, Science 287 (2000), 408. There is insufficient evidence to stop asthma treatment in pregnancy for fears of fetal harm, Lancet 355 (2000), 119. On folic acid fortification of food, Lancet 355 (2000), 147. Poor pregnancy outcome in refugee camps in Tanzania is studied in JAMA 283 (2000), 397-402. The question of prenatal famine and later antisocial behaviour is discussed in JAMA 283 (2000), 887-8.

Pregnancy poses some risk for women who carry the BRCA1 or 2 mutation, Science News 156 (1999), 381. Pregnancy outcome of women with PKU deficiency can be aided by treatment even late in pregnancy, JAMA 283 (2000), 756-62. Maternal blood pressure and birth weight are discussed in Lancet 355 (2000), 81-83. A call to end advertising of formula milk in office settings is O&G 95 (2000), 296-303. Breast milk has immunological advantages for people in developing countries, Lancet 355 (2000), 451-5.

The estimated spontaneous fetal loss rate for Down syndrome fetuses is 36% for 10 weeks, and 30% for 12 weeks, and 21% for 16 weeks, Prenatal Diagnosis 19 (1999), 1177-80. A mutation in G6PD may increase risk for miscarriage, NS (15 Jan. 2000), 4. Intrauterine lead exposure may be associated with preterm birth only in the first pregnancy, Environmental Research 81 (1999), 297-301. A study that shows how technology needs to be adapted to local ideas is Tautz, S. et al. "Between fear and relief: how rural pregnant women experience foetal ultrasound in a Botswana district hospital", SSM 50 (2000), 689-701. There will be 10-20% reduction in the rebate for ultrasound during pregnancy in Australia, Lancet 355 (2000), 298. On mother-child relationship, Lancet 355 (2000), 498-9. Hormones may alter father's behaviour to their children, NS (8 Jan. 2000), 8.

Giving guidance on child discipline to avoid physical punishment is discussed in BMJ 320 (2000), 261-2; NEJM 342 (2000), 361-2. There is new advice in the UK to prevent sudden infant death, BMJ 320 (2000), 335.

A review of fetal protection in Wisconsin child abuse law is JLME 27 (Winter 1999), 332-47. The question of fortifying baby food with DHA and AA fatty acids is discussed in NS (18 March 2000), 16-7. A survey in Christchurch New Zealand found 62% of women used folic acid at some stage of pregnancy but only 17% had taken preconceptually, NZ Medical J. 112 (1999), 463-5. Letters on neural tube defects are in NEJM 342 (2000), 1135-7. A Bolivian study on the influence of intergenerational education on women’s health behaviour is SSM 50 (2000), 1189-96. The results of a 12 year maternal PKU study are in Am. J.0&G. 182 (2000), 326-33. A study of birthweight and mortality is in BMJ 320 (2000), 647-8, 839-41. On anti-depression medications, JAMA 283 (2000), 1139. Semen from workers exposed to hydrocarbons is damaged, F&S 73 (2000), 221-8. A study of the effect of economic sanctions on mortality of Iraqi children is AJPH 90 (2000), 546-52.

A book review of The Tragedy of Childbed Fever, is NS (March 2000), 52-3. Breast feeding was banned on 6 April, 2000 from the British Parliament on grounds eating was not allowed. Nestle has been accused of breaking the international code on promoting bottled milk, BMJ 320 (2000), 468. A Turkish study found women dissatisifed with C-section, SSM 50 (2000), 1227-33. An Irish case involving home births is discussed in Lancet 355 (2000), 1084. A book review on circumcision is Lancet 355 (2000), 1107. On pain in neonates, Lancet 355 (2000), 932-3.

The relationship between finger-length ratios and sexual orientation is discussed in Nature 404 (2000), 455; NS (1 April 2000), 5. Finger length is a measure of prenatal exposure to testosterone. Sickness and sex of the child is discussed in Lancet 355 (2000), 756. Neglect of premature babies may be a cause for delayed language difficulties, NS (1 April 2000), 18. Neonatal screening for hearing impairment is discussed in Lancet 355 (2000), 413-4. Recognition of television images is one measure of development in young children, BMJ 320 (2000), 836-8. The risks of suffocation and SIDS are discussed in AJPH 90 (2000), 527-31.

Carriers of the G protein beta3 subunit b25TT genotype are at higher risk for obesity and post-pregnancy weight retention if they do not exercise properly, Lancet 355 (2000), 1201, 1240-2. Humour is a result of childhood not genes, NS (15 April 2000), 13.

A new book is Berer, M. & Ravindran, TKS, eds., Safe Motherhood Initiatives: Critical Issues (Blackwells, Reproductive Health Matters, 1999, 244pp.). Japanese tradition of returning to the hometown in last months of pregnancy is one reason for a higher rate of maternal mortality in Japan than many industrialized countries, JAMA 283 (2000), 2712-4, 2661-7; Lancet 355 (2000), 1977. Fetal exposure to methamphetamine is discussed in JAMA 283 (2000), 2225-6. On folic acid fortification of foods, NEJM 342 (2000), 1442-5. Claims that events before birth cause cerebral palsy are disputed, BMJ 320 (2000), 1626. The prevalence of HTLV and HIV in the UK are similar, and there are calls for screening of both, BMJ 320 (2000), 1497-501. Mosquitoes prefer pregnant women, BMJ 320 (2000), 1558. Non-life threatening fetal surgery is debated in NS (6 May 2000), 18-9. Entry into prenatal care in the USA is discussed in JAMA 283 (2000), 2924-5. On fetal surveillance, Lancet 355 (2000), 1823.

Folic acid pathway mutations are found in patients with neural tube defects, AJMG 95 (2000), 216-23. Folic acid fortification of flour has raised US serum levels of folate, BMJ< 321 (2000), 1176. On vitamin A deficiency, Lancet Perspectives 356 (2000), s41. Lower childhood intelligence scores are linked to late onset dementia, Lancet< 356 (2000), 1907. Also on health impact of low birth weight, Lancet 356 (2000), 2066-7. X-rays in the womb may be linked to mental illness in adulthood, NS (18 Nov. 2000), 14.

On childbirth, <Lancet Perspectives 356 (2000), s12. A relationship between private health insurance and higher rates of cesarean section is found in Chile, BMJ 321 (2000), 1501-5. Cesarean section rates are increasing still, Lancet 356 (2000), 1677-80, 1697; AWHONN 4 (Oct. 2000), 11-5.

The separation of Siamese twins in the UK on 7 November, is reported in Lancet< 356 (2000), 1661; BMJ 321 (2000), 1175. The success rate is discussed in Lancet 356 (2000), 1765; NS (11 Nov. 2000), 6. The ethical issues are discussed in BME 162 (2000), 13-8.

The planned trial of ritalin to treat attention deficit hyperactivity disorder (APHD) raises ethical issues, Science 290 (2000), 1280-2. A letter on a clinical trial for Ritalin to treat preschool children with APHD is discussed in Science 290 (2000), 1280, 1897; BMJ 321 (2000), 975-6. Children today may be more stressed than in the past, Time (15 Jan. 2001), 58; NS (16 Dec. 2000), 34-9. Views on consent for neonatal clinical trials are discussed in Mason, S. et al. “Obtaining informed consent to neonatal randomised controlled trials: interviews with parents and clinicians in the Euricon study”, Lancet 356 (2000), 2045-51, 2026-7; BMJ 321 (2000), 1093-4. Pediatric obsessive-compulsive disorder is discussed in JAMA 284 (2000), 3104-6. On media portrayals of breast feeding, BMJ 321 (2000), 1196-8. Influence of potty training on dysfunctional bladder is discussed in Lancet 356 (2000), 1787. Child abuse and deaths are discussed in Lancet Perspectives< 356 (2000), s13-4; Lancet 356 (2000), 1571-2.

The UK is tightening the law on female circumcision, BMJ 321 (2000), 1365. In general, Lancet Perspectives< 356 (2000), s57. Baby trafficking in China is discussed in Time (8 Jan. 2001), 16-7.

A study showing that prenatal care is appreciated among African-American women, despite their current lower use of the services, in the USA, AJPH 91 (2001), 105-11. Use of misoprostol in pregnancy is discussed in NEJM 344 (2001), 59-60. A book review of Fetology is in NEJM 344 (2001), 236-7; and on habituation technique in fetal behaviour, Lancet 357 (2001), 328-9. Maternal smoking alters fetal biochemistry, O&G 97 (2001), 57-61. Fetal origins of adult disease are discussed in Lancet 357 (2001), 405. A study of substance abuse in pregnancy in California is SSM 52 (2001), 571-83. Use of non-steriodal antiinflammatory drugs in pregnancy has some higher risk of miscarriage, but not a risk of adverse birth outcome, BMJ 322 (2001), 266-70.