Title: Articles of Interest.
For interest...
BB Jackie Mawson.
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bmj.com Customised @lerts: Press Releases for Saturday, 05 January 2002
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eBMJ -- Press Releases
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Releases Saturday 05 January 2002
No 7328 Volume 324
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(1) SMOKING IN PREGNANCY LINKED TO DIABETES AND OBESITY IN OFFSPRING
(3) TEENAGE PREGNANCIES LINKED TO ONE PARENT FAMILIES
(5) DOCTORS ARE LAYING THEMSELVES OPEN TO NEGLIGENCE CLAIMS
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(1) SMOKING IN PREGNANCY LINKED TO DIABETES AND OBESITY IN OFFSPRING
(Smoking during pregnancy and diabetes mellitus in a British longitudinal
birth cohort)
http://bmj.com/cgi/content/full/324/7328/26
Smoking during pregnancy increases the risk of the child developing
diabetes and obesity in later life, find researchers from Sweden in this
week's BMJ. They also show that cigarette smoking as a young adult is
associated with an increased risk of subsequent diabetes.
The authors used British data on about 17,000 births from 3 to 9 March 1958
to conduct their study. At birth, midwives recorded information on smoking
during pregnancy (after the 4th month). Details of maternal smoking were
again recorded in 1974. The group's own smoking behaviour was recorded
during an interview at age 16.
Medical examinations and record reviews were conducted at ages 7 and 16
years, and a personal interview at age 33 years asked about diabetes. Among
those followed fully throughout childhood and adolescence to age 33, the
authors identified 15 men and 13 women who had developed diabetes between
16 and 33 years, and 602 individuals (10%) who were obese at age 33.
The association of diabetes with maternal smoking specifically during
pregnancy suggests that it is a true risk factor for early adult onset
diabetes, say the authors. Cigarette smoking as a young adult was also
independently associated with an increased risk of subsequent diabetes.
Study members without diabetes, but whose mothers smoked during pregnancy,
were significantly more likely to be obese or overweight by age 33 years.
They suggest that in utero exposure to smoking results in lifelong
metabolic dysregulation, possibly due to fetal malnutrition or toxicity,
and stress that smoking during pregnancy should always be strongly
discouraged.
Contact:
Scott Montgomery, Principal Research Fellow, Enheten for Klinisk
Epidemiologi, Stockholm, Sweden
Email: [EMAIL PROTECTED]
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(3) TEENAGE PREGNANCIES LINKED TO ONE PARENT FAMILIES
(Teenage pregnancies are influenced by family structure )
http://bmj.com/cgi/content/full/324/7328/51/a
Without better marriage education and support in the United Kingdom,
teenage pregnancy rates are likely to remain high even with increasing
availability of contraceptives, suggests a letter in this week's BMJ.
Trevor Stammers of St George's Hospital Medical School in London reports
that young people aged 14-17 who live in a two parent family are less
likely to have ever had sexual intercourse than young people living in any
other family arrangement, even after factors such as race, age, and
socioeconomic deprivation are taken into account.
This is hardly surprising, as children whose parents talk to them about
sexual matters and provide sexuality education at home are more likely than
others to postpone sexual activity, he suggests.
Cohabitations are four times more likely to break up than marriages and
less than 4% of cohabitations last 10 years or more, so children born
outside of marriage stand little chance in their teenage years of being in
the optimal family structure associated with the lowest risk of unplanned
pregnancy, he concludes.
Contact:
Trevor Stammers, Tutor in General Practice, St George's Hospital Medical
School, London, UK
Email: [EMAIL PROTECTED]
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(5) DOCTORS ARE LAYING THEMSELVES OPEN TO NEGLIGENCE CLAIMS
(Informed consent: lessons from Australia )
http://bmj.com/cgi/content/full/324/7328/39
In the past decade, both English and Australian courts have adopted a more
patient centred standard in deciding what risks doctors must disclose to
patients. Yet, in Australia many doctors still do not understand their
legal duties and many are being held liable for their failure to inform,
argue Loane Skene and Richard Smallwood in this week's BMJ.
They suggest that there are probably lessons here for Britain, and other
countries with similar legal systems.
Recent judgements in both English and Australian courts suggest that judges
are moving away from accepting what "a reasonable body of doctors" might do
to supporting what "a reasonable patient" might expect. This practice is
part of a wider social movement in both countries to give greater weight to
individual rights, and professional bodies in each country have issued
guidelines to help explain the law to doctors.
Yet, despite these guidelines, and several high profile negligence cases in
Australia, a recent survey of doctors in Victoria and Tasmania found that
many still did not know, or misunderstood, their legal obligations.
A similar survey of British doctors' knowledge and practice might be
useful, say the authors. The Australian experience suggests that there is
still much work needed to minimise future litigation and promote patient
care, they conclude.
Contact:
Loane Skene, Professor of Law, University of Melbourne, Victoria, Australia
Email: [EMAIL PROTECTED]
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