Smoking rates among American Indian women giving birth in Minnesota. A call to action.

Maternal smoking is associated with a number of adverse effects including neonatal mortality, preterm delivery, low birth weight, decreased lung growth and function, and increased incidence of lower respiratory infections. This study looked at smoking trends among American Indian and white women in Minnesota who gave birth between 1999 and 2003. The authors used data from birth certificates issued by the state to determine the rate of smoking among both groups of women. They broke down the data further to look at and compare smoking rates of American Indian and white women based on where they gave birth (greater Minnesota or the Twin Cities metro area), when they began receiving prenatal care, their level of education, their age, the number of children they already had, and the weight of their baby. They found that 39% of American Indian women in Minnesota who gave birth during that period reported smoking, compared with 11% of white women. In addition, their findings showed that cigarette use among American Indian women in Minnesota who gave birth in 2003, was 36.5%--double the national rate of 18.3% forAmerican Indian women.

Enhanced pregnancy-associated mortality surveillance: Minnesota, 1990-1999.

Comprehensive surveillance is critical to accurate identification of pregnancy-associated deaths and risk factors and is the first step in implementing programs to prevent such deaths in young women. In Minnesota, surveillance is currently based on analysis of data from death records. This study sought to demonstrate that the state's current surveillance method underestimates the actual burden of maternal deaths in Minnesota. It proposes that ongoing enhanced surveillance--analysis of death certificate data combined with the linking of death records of women of reproductive age with live birth records or fetal death records--provides a more complete and accurate accounting of pregnancy-associated mortality in Minnesota.

Obstetrics and gynecology--to be or not to be? Factors influencing one's decision.

OBJECTIVE: The study was undertaken to determine factors influencing a medical student's decision to choose obstetrics and gynecology (OB/GYN) versus another specialty. STUDY DESIGN: Medical school graduates from 1991 to 2001 were surveyed about factors influencing their specialty choice. Data were analyzed with chi(2), logistic regression, and odds ratio where appropriate. RESULTS: Of 1128 surveys, 562 (50%) were returned; 37% of respondents were women and 63% were men; and 73 (13%) chose OB/GYN. Statistically significant positive influences included student sex, second-year rotations, OB/GYN staff, continuity of patient care, primary care opportunities, surgical opportunities, healthy patient population, female patients, lifestyle, and financial opportunities. CONCLUSION: Perceived lifestyle, primary care opportunities, and malpractice concerns did not influence the choice to enter the field of OB/GYN. Also, the perception of patient's desire for female physicians had no apparent influence, either positive or negative, in the decision process.