We examined the effects of short interpregnancy intervals on small-for-gestational age and preterm births in a biracial population using North Carolina birth certificate data from 1988 to 1994. We defined small-for-gestational age birth as being below the 10th percentile on a race-, sex-, and parity-specific growth curve after a gestation of 37-42 weeks. We defined preterm birth as a gestation of less than 37 weeks. We analyzed birth records from all eligible singleton births to black or white women ages 15-45 years after an interpregnancy interval of 0-3 months (N = 11,451) and a random sample of singleton births after an interval of 4-24 months (N = 23,118). We defined interpregnancy interval exposure categories as 0-3, 4-12, and 13-24 months. The multivariate adjusted odds ratio for small-for-gestational age births after interpregnancy intervals of 0-3 months compared with 13-24-month intervals was 1.6 (95% confidence interval = 1.4-1.8). The odds ratio for preterm birth after interpregnancy intervals of 0-3 months was 1.2 (95% confidence interval = 1.1-1.3). Odds ratios did not vary substantially by race for either outcome.

Objective: To determine whether adverse perinatal outcome is associated with asthma or asthma medication use during pregnancy.Methods: A retrospective cohort study was conducted of women who resided in Halifax County, Nova Scotia, and delivered between 1991 and 1993. Asthmatic women were classified into three groups, according to medication usage: no medications, beta agonists only, and steroids with or without other asthma medications. Outcomes compared among asthmatic and nonasthmatic women included maternal complications (pregnancy-induced hypertension, cesarean delivery, gestational diabetes, preterm birth, and antepartum and postpartum hemorrhage) and neonatal outcomes (low birth weight, congenital malformations, hyperbilirubinemia, and respiratory distress syndrome).Results: The cohort included 817 asthmatic women and 13,709 nonasthmatic women. Overall, the prevalence of pregnancies complicated by asthma increased from 4.8% in 1991 to 6.9% in 1993. Asthmatic women were at increased risk for antepartum and postpartum hemorrhage, independent of medication usage. Asthmatic women taking steroids were at increased risk for pregnancy-induced hypertension (odds ratio [OR] 1.7; 95% confidence interval [CI] 1.0, 2.9). The only significant difference in neonatal outcome between asthma medication groups and nonasthmatic women was of an increased risk of hyperbilirubinemia in infants of women taking steroids (OR 1.9; 95% CI 1.1, 3.4).Conclusion: Risk of antepartum and postpartum hemorrhage is increased in asthmatic women, independent of medication usage. The increased incidence of neonatal hyperbilirubinemia and the borderline increased risk of pregnancy-induced hypertension may be complications of steroid use or may be related to poorly controlled asthma. (Obstet Gynecol 1998;92:435-40.

Pharmacy practice research is a relatively new discipline which is vital to the development of the pharmacist's professional role, both in the hospital service and in community practice. In 1991, a pharmacy practice research group was set up in South East Thames regional health authority, England, and its members set as a priority the need to develop a regional database of previous and ongoing pharmacy practice research that would be easily accessible to pharmacists within the region and elsewhere. At the same time, the opportunity was taken to survey the perceived barriers to practice research within the region. The survey demonstrated a steady increase in practice research projects undertaken within the region over the past decade, although this partly reflected an increase in the number of research projects imposed by preregistration training requirements or postgraduate qualifications. The most common reason for initiating research was to support a local service development; only 19 per cent had been initiated as a result of “personal interest”. Collaborative research with other professions, but not between pharmacists, was reported. A disappointingly low rate of publication of project results was noted. The main barriers to research were identified as lack of time and lack of funding. The survey results have enabled measures that might encourage practice research within the region to be identified and implemented.