This compendium lists drugs in alphabetical order, with each discussed under fetal risk and breast-feeding summaries. A list of recent references is included. Since the previous edition, published in 1990, more than 100 new drugs have been added. The authors have included animal studies, but they correctly point out that, although such studies may be predictive for the human, the accuracy depends on the species used and other factors. Much of the original information was derived from the collaborative Perinatal Project published in Birth Defects and Drugs in Pregnancy in 1977 and has been the "gold standard" for teratologists. This edition includes, however, data from a more recent and larger surveillance that covers more than 229 000 completed pregnancies over a 7-year period (1985 through 1992) from the Epidemiology and Surveillance Center for Drugs and Biologicals of the US Food and Drug Administration. The authors established a risk factor for

Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk

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Dental management of the medically compromised patient

The aims of this study were to assess women's knowledge and experiences of dental health in pregnancy and to examine the self-care practices of pregnant women in relation to their oral health. Women in the postnatal ward at the Women's and Children's Hospital, Adelaide, completed a questionnaire to assess their knowledge, attitudes and practices to periodontal health. Pregnancy outcomes were collected from their medical records. Results were analysed by chi-square tests, using SAS. Of the 445 women enrolled in the survey, 388 (87 per cent) completed the questionnaire. Most women demonstrated reasonable knowledge about dental health. There was a significant association between dental knowledge and practices with both education and socio-economic status. Women with less education and lower socio-economic status were more likely to be at higher risk of poor periodontal health compared with women with greater levels of education and higher socioeconomic status. Most women were knowledgeable about oral and dental health. Lack of knowledge about oral and dental health was strongly linked to women with lower education achievements and lower socioeconomic backgrounds. Whether more intensive dental health education in pregnancy can lead to improved oral health and ultimately improved pregnancy outcomes requires further study.

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Oral and dental health care practices in pregnant women in Australia: a postnatal survey

Objectives. We examined the relationships between risk factors amenable to intervention and the likelihood of dental care use during pregnancy. Methods. We used data from the Washington State Department of Health’s Pregnancy Risk Assessment Monitoring System. Results. Of the women surveyed, 58% reported no dental care during their pregnancy. Among women with no dental problems, those not receiving dental care were at markedly increased risk of having received no counseling on oral health care, being overweight, and using tobacco. Among women who received dental care, those with dental problems were more likely to have lower incomes and Medicaid coverage than those without dental problems. Conclusions. There is a need for enhanced education and training of maternity care providers concerning oral health in pregnancy.

Dental care use and self-reported dental problems in relation to pregnancy.

Background: The aim of this study is to perform an updated systematic review and meta-analysis of randomized controlled trials (RCTs) evaluating the efficacy of scaling and root planing (SRP) in reducing the preterm-birth and low-birth-weight risks to analyze important subgroups and to further explore heterogeneity and bias risks in the pooled studies.Methods: The entire Cochrane Library was searched (from 1990 to September 2011), MEDLINE (from 1950 to September 2011), CINAHL (from 1980 to September 2011), University of Michigan School of Dentistry “Dentistry and Oral Sciences” database (from 1990 to September 2011), conference proceedings, and the ClinicalTrials.gov database. Authors were contacted when clarification was needed. Selection criteria included the following: 1) RCTs that reported preterm-birth risk ( 4 mm or clinical attachment loss >2 mm for ≥1...

Scaling and root planing treatment for periodontitis to reduce preterm birth and low birth weight: a systematic review and meta-analysis of randomized controlled trials.

The purpose of this article is to explore how poor oral health affects pregnancy and to review current recommendations for dental care during pregnancy. While nurses are concerned with numerous aspects of the health of pregnant women, the health of maternal and fetal dentition may be overlooked. However, due to recent findings that periodontal disease may be a risk factor for preterm low birthweight, nurses and other maternal healthcare providers are becoming more aware of oral health during pregnancy. It is important to understand that establishing a healthy oral environment is the most important objective in planning the dental care for the pregnant patient. This objective is achieved by adequate plaque control (brushing and flossing) and professional prophylaxis including coronal scaling, root planing, and polishing. Nurses, nurse practitioners, and nurse-midwives should include assessment of maternal dentition and referral for dental problems as part of their prenatal practice. Patients should be encouraged to schedule elective dental treatment during the second trimester but seek prompt care for acute dental problems. Teaching related to oral health during pregnancy should include the importance of proper nutrition to ensure maternal and fetal oral health, including taking prenatal vitamins and eating foods high in protein, calcium, phosphorus, and vitamins A, C, and D. Potential teratogens that may be encountered during dental care should also be discussed. Nurses can be vital in improving perinatal outcomes and maternal/fetal dental health through screening, referral, and education of their pregnant clients.

Lisa Winters Mills

Papers

Oral health during pregnancy.