Higher Marijuana use among Young Adults Persists Even during Pregnancy.

Background: Marijuana is linked to adverse pregnancy health effects, yet limited data exist regarding demographic and regional differences in marijuana use during pregnancy.

Objective: To determine the prevalence of prenatal marijuana use among reproductive-age women and assess regional and age-related differences.

Methods: This study secondarily analyzed cross-sectional, population-based Pregnancy Risk Assessment Monitoring System data from states querying about marijuana use.

Impact of Teaching Sexual Health Education on Medical Students.

Background And Objectives: Physician discomfort, embarrassment, and perceived lack of time and/or training all play a role in preventing physicians from discussing sexual health with patients. Past research shows this discomfort begins in medical school. We aimed to determine whether teaching sexual health education increases medical students' self-efficacy in discussing sexual health topics with adolescents.

Sex Ed by Brown Med: A Student-Run Curriculum and Its Impact on Sexual Health Knowledge.

Background And Objectives: Risky sexual behavior among adolescents is a public health crisis. We describe a novel approach to sexual health education where medical students manage a curriculum for an entire seventh grade in one Rhode Island city to better equip students with comprehensive knowledge about sexual health.

Methods: Medical students were trained to teach 12 sessions to seventh-grade students under the supervision of the classroom teacher using a curriculum designed by medical students and faculty (modeled on the Family Life and Sexual Health [FLASH] curriculum but tailored to meet the community's needs).

Family Medicine Maternity Care Call to Action: Moving Toward National Standards for Training and Competency Assessment.

Maternity care is an integral part of family medicine, and the quality and cost-effectiveness of maternity care provided by family physicians is well documented. Considering the population health perspective, increasing the number of family physicians competent to provide maternity care is imperative, as is working to overcome the barriers discouraging maternity care practice. A standard that clearly defines maternity care competency and a systematic set of tools to assess competency levels could help overcome these barriers.

Medical students help bridge the gap in sexual health education among middle school youth.

Background: School-based programs are important in addressing risky teenage sexual behavior. We implemented a sex education program using trained medical student volunteers.

Methods: Medical students (n=30) implemented a seven-session curriculum, designed by medical students and faculty, to 7th and 8th grade students (n=310) at a local school.

A pilot randomized controlled trial comparing prenatal yoga to perinatal health education for antenatal depression.

We conducted a pilot randomized controlled trial (RCT) comparing a prenatal yoga intervention to perinatal-focused health education in pregnant women with depression. Findings document acceptability and feasibility of the yoga intervention: no yoga-related injuries were observed, instructors showed fidelity to the yoga manual, and women rated interventions as acceptable. Although improvements in depression were not statistically different between groups, they favored yoga.

Teaching maternity care in family medicine residencies: what factors predict graduate continuation of obstetrics? A 2013 CERA program directors study.

Background And Objectives: Maternity care is an essential component of family medicine, yet the number of residency graduates providing this care continues to decline. Residency programs have struggled to identify strategies to increase continuation of obstetric practice among graduates. Leaders in family medicine obstetrics previously proposed a tiered model of training to ensure adequate volume for those desiring to continue maternity care upon graduation.

Newborn well-child visits in the home setting: a pilot study in a family medicine residency.

Background: The purpose of our study was to pilot a home visit program targeting neonates conducted by family medicine residents. While the literature shows that home visit programs are successful at preventing adverse outcomes for young children, such as improving parenting practices and promoting breastfeeding, no data exist about newborn home visits conducted by resident physicians.

Methods: Residents conducted newborn home visits precepted by a family medicine faculty member from June 2012--May 2013.

Potential for prenatal yoga to serve as an intervention to treat depression during pregnancy.

Background: When left untreated, antenatal depression can have a serious negative impact on maternal, and infant outcomes. Many affected women do not obtain treatment for depression owing to difficulties accessing care or because they do not find standard antidepressant treatments to be acceptable during pregnancy. This study examined the acceptability and feasibility of a gentle prenatal yoga intervention, as a strategy for treating depression during pregnancy.

Maternal-child health fellowship: maintaining the rigor of family medicine obstetrics.

Background And Objectives: The United States has a growing shortage of maternity care providers. Family medicine maternity care fellowships can address this growing problem by training family physicians to manage high-risk pregnancies and perform cesarean deliveries. This paper describes the impact of one such program-the Maternal Child Health (MCH) Fellowship through the Department of Family Medicine at Brown University and the careers of its graduates over 20 years (1991--2011).

Maternal-fetal attachment differentiates patterns of prenatal smoking and exposure.

Objective: Smoking cessation during pregnancy may reflect altruistic motives on behalf of the unborn baby. We test the hypothesis that pregnancy quitters have higher maternal-fetal attachment than persistent smokers, and secondarily explore how maternal-fetal attachment differs among non-smokers, pregnancy quitters, and persistent smokers.

Methods: Participants were 156 women in the Behavior and Mood in Babies and Mothers study who provided report of smoking throughout pregnancy via timeline follow back interviews, with salivary cotinine confirmation of reported cessation at 30 and 35 week gestation, and postpartum day one.

Promotion of family-centered birth with gentle cesarean delivery.

Purpose: In this commentary we describe our experience developing a "gentle cesarean" program at a community hospital housing a family medicine residency program. The gentle cesarean technique has been popularized in recent obstetrics literature as a viable option to enhance the experience and outcomes of women and families undergoing cesarean delivery.

Methods: Skin-to-skin placement of the infant in the operating room with no separation of mother and infant, reduction of extraneous noise, and initiation of breastfeeding in the operating room distinguish this technique from traditional cesarean delivery.

Developing future leaders in reproductive health through a scholarly concentration for medical students.

Objectives: To evaluate the impact of a scholarly concentration for medical students, which aims to develop students' research, clinical and advocacy skills to promote women's reproductive health.

Study Design: Scholarly concentration programs provide opportunities to engage in scholarship beyond the traditional medical school curriculum. Faculty from the Family Medicine and Obstetrics and Gynecology Departments at Brown University collaboratively developed the Scholarly Concentration in Women's Reproductive Health.

Maternal history of adoption or foster care placement in childhood: a risk factor for preterm birth.

Objective: The objective of the study was to assess the impact of maternal history of adoption or foster care placement in childhood on the risk for preterm birth (PTB), controlling for other known risk factors for PTB.

Study Design: Participants were 302 pregnant women from a low-income, diverse sample drawn from 2 intensive prospective studies of maternal mood and behavior and fetal and infant development. Gestational age was determined by best obstetric estimate.

The relationship between maternal-fetal attachment and cigarette smoking over pregnancy.

Cigarette smoking during pregnancy is one of the most preventable causes of infant morbidity and mortality, yet 80 % of women who smoked prior to pregnancy continue to smoke during pregnancy. Past studies have found that lower maternal-fetal attachment predicts smoking status in pregnancy, yet past research has not examined whether maternal-fetal attachment predicts patterns or quantity of smoking among pregnant smokers. The aim of this study was to examine the relationship between maternal-fetal attachment and patterns of maternal smoking among pregnant smokers.

Low cost, high yield: simulation of obstetric emergencies for family medicine training.

Background: Simulation is now the educational standard for emergency training in residency and is particularly useful on a labor and delivery unit, which is often a stressful environment for learners given the frequency of emergencies. However, simulation can be costly.

Purpose: This study aimed to assess the feasibility and effectiveness of low-cost simulated obstetrical emergencies in training family medicine residents.

Mercury, lead, and cadmium in umbilical cord blood.

The study described in this article aimed to determine if measurable levels of mercury, lead, and cadmium are detected in the umbilical cord blood specimens collected in a community hospital in Rhode Island and if prenatal exposure correlates with prematurity or fetal growth indicators. Total mercury, lead, and cadmium concentrations were measured in 538 specimens of cord blood and correlated with demographic characteristics and pregnancy outcomes for each mother-infant pair. Lead concentrations determined in the cord blood of Rhode Island women (geometric mean 0.

Neonatal herpes infection: case report and discussion.

Neonatal herpes simplex virus (HSV) infections are often life-threatening. Although sometimes difficult to diagnose, most infections can be treatable when found early. Infection with HSV should be kept high on the differential diagnosis of a febrile newborn younger than 1 month old, and treatment should be strongly considered for infants with certain risk factors, even before definitive culture or polymerase chain reaction results are available.