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Beta-sympathomimetic drugs, also called beta-agonists, are commonly used to prevent premature labor. In the US, ritodrine and terbutaline (also called tocolytic agents) are the most popular drugs used for this purpose. Recently, a beta-sympathomimetic drug called isoxsuprine was removed from the market because it produced undesirable side effects. To determine if treating pregnant women with beta-sympathomimetic drugs is harmful to infants with low birth weights (less than 3.3 pounds), 331 infants were studied. Two-hundred and one of the infants were born to mothers that had been treated with either isoxsuprine (33), ritodrine (70), terbutaline (43), or a combination of these drugs (55). One-hundred and thirty infants of similar birth weight who were born to mothers that had not received any of these drugs during pregnancy were included for comparison (controls). There were no differences in the growth and development of the infants who were exposed to these drugs while in the uterus compared with the controls. Mortality appeared to be lower among the infants born to mothers who had been treated with ritodrine or terbutaline than those born to mothers who had not been treated. However, it is not certain whether the lower mortality is related to the drug treatment. Further studies will be needed to verify these findings. The results of this study indicate that treatment with ritodrine or terbutaline does not appear to have any adverse effects on infants with low-birth-weight. (Consumer Summary produced by Reliance Medical Information, Inc.)

Preeclampsia is a common disorder in pregnant women and features blood vessel spasm, edema (fluid accumulation), protein in urine, defects in clotting, and kidney and liver dysfunction. The disorder is puzzling, as the cause is unknown, but many of the problems might be explained by damage to and generalized dysfunction of the endothelium, smooth cells that line blood vessels. Studies in which blood from women with preeclampsia has been shown to injure laboratory-grown endothelial cells suggest that the blood contains a factor mediating the endothelial damage. Other studies suggest that a circulating growth factor (any of a group of proteins which can stimulate cell growth) may be associated with the damage. To determine whether a growth factor is a cause of or an effect of endothelial damage in women with preeclampsia, blood studies in six women with preeclampsia and six healthy pregnant women were conducted. Blood samples were available from the first trimester. As expected, women with preeclampsia had higher blood pressure and higher levels of uric acid in blood and protein in urine, and they tended to be younger and deliver lower-birth-weight infants. Blood pressures differed significantly among the two groups by the second trimester, but this was not diagnostically significant until the third trimester. Proteinuria was only noted in the third trimester. Growth factor levels were highest during the first two trimesters in women who eventually developed preeclampsia. Growth factor levels were similar between groups by six weeks postpartum. The results suggest that elevated growth factor levels precede development of preeclampsia symptoms by months, equivalent to the time frame when the most important disease changes involving placental and implantation occur. The study suggests that release of growth factor by damaged endothelial cells is an early sign of preeclampsia. (Consumer Summary produced by Reliance Medical Information, Inc.)

Fetal heart rate (FHR) variability is thought to be an important index of fetal health. In the presence of normal variability, the fetus is vigorous, but lack of beat-to-beat variability may be associated with fetal compromise. A distinction between short-term variability (STV) (beat-to-beat changes between successive beats) and long-term variability (LTV) (rhythmic fluctuations in FHR) has not been made to date. We have utilized computer programs to compare three pairs of mathematical indices and one visual index of FHR variability. Among the three pairs of indices designed for detection of STV and LTV, de Haan's short-term and long-term indices exhibited the least interdependence, and the long-term index was completely insensitive to artificially generated pure STV. Yeh's short-term and long-term indices exhibited substantial positive interdependence. Hon's visual index appears to detect LTV primarily rather than STV. When the effect of progression of labor on FHR variability was examined, no conclusions were possible because of inconsistencies between patients. Ultimately, the clinical value of any one of these indices awaits testing of their ability to define fetal well-being or fetal distress.

We tested 383 women with and 500 women without cervical neoplasia for antibodies against Chlamydia trachomatis or herpes simplex virus (HSV). Exposure to both agents was related to sexual activity, with the highest prevalence of antibodies found in women with more sex partners and who had first coitus at an earlier age. When subjects were matched for several risk factors (age, race, marital status, parity, number of sex partners, and history of venereal disease), a significant excess of antibodies against C trachomatis was found in cases as compared with control subjects (76.5% v 58.4%, respectively; n=149). Because matched-pair analysis lost a substantial proportion of women with neoplasia (largely because they were older), linear logistic analysis was performed. This also showed an excess of antichlamydial antibody in cases, with an estimated odds ratio of approximately 2 for the association of antichlamydial antibody and the risk of being a case. Neither analysis found an excess of antibodies to HSV type 2 in cases.(JAMA 1982;248:2134-2138)