Objective To explore risk factors for postpartum weight retention at one year after delivery in predominantly low income women. Methods Data were collected from 774 women with complete height and weight information from participants in the NICHD Community Child Health Network, a national five-site, prospective cohort study. Participants were enrolled primarily in the hospitals immediately after delivery. Maternal interviews conducted at 1, 6, and 12 months postpartum identified risk factors for weight retention and included direct measurement of height and weight at 6 and 12 months. Logistic regression assessed the independent contribution of postpartum weight retention on obesity. Results Women had a mean prepregnancy weight of 161.5 lbs (BMI 27.7kg/m2). Women gained a mean of 32 lbs while pregnant and had a 1 year mean postpartum weight of 172.6 lbs (BMI 29.4kg/m2). Approximately 75% of women were heavier 1 year postpartum than they were prepregnancy, including 47.4% retaining over 10 lbs and 24.2% over 20 lbs. Women retaining at least 20 lbs were more often African American, younger, poor, less educated, or on pubic insurance. Race and socioeconomic disparities were associated with high pre-pregnancy BMI and excessive weight gain during pregnancy, associations which were attenuated by breastfeeding at 6 months and moderate exercise. Of the 39.8 with normal prepregnancy BMI, one third became overweight or obese 1 year postpartum. Conclusion Postpartum weight retention is a significant contributor to the risk for obesity 1 year postpartum, including for women of normal weight prepregnancy. Postpartum, potentially modifiable behaviors may lower the risk.

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Objective To study the relationship between prenatal marijuana and infant birth weight using natural cohorts established before, during and after the 20-month lapse between legalization and legal recreational sales in Washington State. Study Design Over 5 years, 5,343 pregnant women with documented urine drug screen (UDS) results delivered at Tacoma General Hospital or Good Samaritan Hospital. Maternal medical data were extracted for three delivery cohorts established based on before (T1), during (T2), and after legalization (T3) of recreational marijuana and legalized availability. Univariate and multivariate models were created to study marijuana exposure on infants' birth weight. Results Marijuana exposure increased the risk of low birth weight (LBW; odds ratio [OR] = 1.42, 95% confidence interval [CI]: 1.01–2.01). This was more pronounced in full-term babies (OR = 1.72, 95% CI: 1.10–2.69), and was independently associated with a higher risk for small for gestational age (SGA; OR = 1.51, 95% CI: 1.49–1.53). The associations between marijuana exposure and SGA were maintained in cohort-specific models (OR = 1.53, 95% CI: 1.01–2.32 for T2, and OR = 1.43, 95% CI: 1.01–2.02 for T3, respectively). Conclusion Marijuana exposure verified by UDS was associated with LBW and SGA. However, recreational marijuana legalization and availability did not have direct impact on newborns' risk of LBW or SGA.

The elimination of theophylline (clearance, half-life) was investigated in 50 patients with chronic congestive heart failure (grade III/IV) and in 20 controls. The cardiac diagnosis was based on clinical and hemodynamic parameters. Patients with congestion of the liver showed a significant reduction of the theophylline body clearance to 25.7 ml/kg/h +/- 12.1 vs 68.3 ml/kg/h +/- 14.8 in the control group, and a corresponding prolongation of the half-life to 5.7 h +/- 2.5 vs 3.1 h +/- 1.4 in the control group. The main pathogenetic factor is obviously the functioning hepatic tissue, reflected by the galactose elimination capacity (r = 0.666; P less than 0.01; theophylline clearance vs galactose elimination capacity).

Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this educational activity, the reader should be better able to evaluate the prevalence and natural history of uterine leiomyomas in pregnancy; assess indications for surgical intervention in pregnant patients; manage surgical complications; and select imaging modalities that may determine their origin.

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