RESUMEN
Heroin abuse during pregnancy is associated with 1) fetal growth retardation and neonatal withdrawal syndrome in infants and 2) an increased frequency of abruptio placentae, sexually transmitted diseases, and other complications in mothers. Based on the findings of several small cohort studies, postnatal growth and development of infants whose mothers were addicted to heroin during pregnancy appears to fall within normal variation. In the present study, information about use of heroin and other substances during pregnancy in relation to neonatal outcome was analyzed in 47 heroin-abusing mothers and 80 control women and their respective infants. In addition medical record information was available for postnatal growth follow-up of 28 (58%) of heroin-exposed children and 22 (27.5%) of control infants. Infants born to heroin addicts in this study were significantly (P<.01) smaller at birth but exhibited no increase in the frequency of congenital anomalies compared with controls. Similar to findings of previous investigators, postnatal development of infants born to addicts was not delayed.
RESUMEN
OBJECTIVES: To estimate whether there has been an increase in resident graduates pursuing fellowship training in the currently accredited subspecialties and to compare whether any trend toward subspecialization is similar to those seen in other specialties. METHODS: This descriptive study examined data from the National Residency Match Program for academic years 2000-2012. Annual comparisons were made between the numbers of residents who either pursued careers in their specialty or were accepted into fellowship training in an accredited subspecialty. We compared the numbers in each group who took the American Board of Obstetrics and Gynecology (ABOG) written board examination and who became board-certified. RESULTS: Although the annual number of residency graduates in obstetrics and gynecology remained essentially the same (1,185 ± 56), the proportion of graduates accepted into fellowships increased steadily in all subspecialties (from 7.0% in 2000 to 19.5% in 2012). All other core specialties saw higher proportions of their graduates pursuing subspecialties except for family medicine. Coincident with rises in fellowship programs and positions was eventual increase in trainees who took the ABOG written examination for the first time in the three established subspecialties (maternal-fetal medicine, gynecologic oncology, reproductive endocrinology and infertility) and who became board-certified. CONCLUSION: Like with residents in other specialties, more graduates in obstetrics and gynecology are pursuing accredited subspecialty fellowship training, adding to the complexities of workforce planning. The percent of obstetrics and gynecology residents who pursued accredited subspecialty fellowship training was lower than all but one other specialty.