Health Care Professional Views and Experiences of Complementary and Alternative Therapies in Obstetric Practice in North East Scotland

Abstract

17.31% of those exposed to b-blockers only compared with 14.5% of those receiving only methyldopa; rates for SGA <3rd percentile were 5.53% and 5.50%, respectively. Preterm birth occurred in 24.28% and 26.90% of the b-blocker and methyldopa groups, respectively; stillbirth rates were 0.96% and 0.40%, respectively. Infant hospitalization rates were 5.53% and 3.90%, respectively. Infant death occurred in 2 neonates in the b-blocker group (0.48%) and 6 in the methyldopa group (0.60%). In women with a diagnosis of chronic hypertension, the risk of SGA <10th percentile and hospitalization for RDS, sepsis, or seizures during infancy were higher in infants of mothers who were given bblockers compared with those whose mothers received methyldopa (21.23% vs. 12.92% for SGA <10th percentile and 8.94% vs. 4.68% for hospitalization). After adjustment for the time of initiation of antihypertensive drugs, the rates of SGA (both <10th and <3rd percentiles) and hospitalization for RDS, sepsis, or seizures during infancy were significantly higher for infants born to mothers given b-blockers compared with those given methyldopa. For women with gestational hypertension or preeclampsia/ eclampsia, no statistically significant differences in the incidence of adverse perinatal outcomes were seen between the 2 groups, except for preterm birth, for which the rate was higher in the methyldopa group (28.31% vs. 21.52%).These results add to the accumulating evidence for the association between antihypertensive medications and adverse perinatal outcome, especially the impact of bblockers used for treating chronic hypertension during pregnancy. Future studies are needed to examine the effect of individual b-blocker medications more thoroughly. Topic: Systems-based PracticeO n the basis of the World Health Organization's definition of complementary and alternative medicine (CAM), the scope of CAM can include acupuncture, aromatherapy, herbal medicines, and spiritual healing. Few CAM therapies are based on or supported by robust efficacy or safety data. Yet, the use of CAM is widespread, with women the major users, including those who are pregnant or undergoing fertility treatment. This study was undertaken to investigate the experience with CAM therapies of health care professionals involved in caring for pregnant women and to identify key predictors of CAM use.The 135 participants were all health care professionals involved in the care of parturients in North East Scotland. A pilot questionnaire was developed from published literature on CAM-related health care professional recommendations to pregnant women. After a pilot study, the questionnaire was reviewed and minor modifications made. The final version had 3 sections of closed questions and Likert-type statements on the use of CAM in pregnant women, factors influencing decision making, attitudes toward the use of CAM in pregnancy, and personal and practice demographics. Data were coded and analyzed using descriptive statistics. Variables considered as significant in univariate analysis w...