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danstr

Published Letters: 273
Editor's Choice: 61

Monday, March 27, 2006 01:51 PM
Original article: No rest for mommy?

No, there isn't evidence.....

we epidemiologists didn't dig into the older literature because we're not writing a scientific paper, here, we're simply commenting on some observations, broadening the discussion a bit. However, the older literature tends to be of lower quality - people didn't understand the need for randomization, double-blinding, and other practices that are now standard. I looked up PJ Whalley, and did not see any papers that address the bed rest question, although she did leave a fair body of publications, including pre-1976 work. Baha Sibai likewise, but again I didn't see a specific piece of work of his addressing the bed rest question. SOme of his more recent papers advise against it.

I do hope you weren't referring to me when you said "check with experts before you tell women to take their baby's life and health for granted for their own comfort." First, I wasn't telling anyone to take their babies life and health for granted, second, I am one of the experts - I'm a founding member of the Society for Perinatal and Pediatric Epdemiology and have done quite a bit of research in this field. I assume, therefore, since you didn't know that, that you weren't talking to me.

I'm glad bed rest worked for you - one of the foundations of medical research is that statistical, population findings do not apply to individuals. However, the converse is also true - your individual experience does not generalize, and you should not give advice based on what worked for you. Checking with your doctors is fine, but they are foremost clinicians, and may not be informed about or trained in understanding the research literature.

Finally, here's a sample article abstract reviewing the question of bed rest:

Cochrane Database Syst Rev. 2005 Apr 18;(2):CD003576.

Bed rest during pregnancy for preventing miscarriage.

Aleman A, Althabe F, Belizan J, Bergel E.

BACKGROUND: Miscarriage is pregnancy loss before 23 weeks of gestational age and it happens in 10% to 15% of pregnancies depending on maternal age and parity. It is associated with chromosomal defects in about a half or two thirds of cases. Many interventions have been used to prevent miscarriage but bed rest is probably the most commonly prescribed especially in cases of threatened miscarriage and history of previous miscarriage. Since the etiology of miscarriage in most of the cases is not related to an excess of activity, it is unlikely that bed rest could be an effective strategy to reduce spontaneous miscarriage. OBJECTIVES: To evaluate the effect of prescription of bed rest during pregnancy to prevent miscarriage in women at high risk of miscarriage. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group trials register (July 2004). In addition, we searched The Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, POPLINE, LILACS and EMBASE. SELECTION CRITERIA: We included all published, unpublished and ongoing randomized trials with reported data which compare clinical outcomes in pregnant women who were prescribed bed rest in hospital or at home for preventing miscarriage compared with alternative care or no intervention. DATA COLLECTION AND ANALYSIS: Two authors independently assessed the methodological quality of included trials using the methods described in the Cochrane Reviewers' Handbook. Studies were included irrespective of their methodological quality. MAIN RESULTS: Only two studies including 84 women were identified. There was no statistically significant difference in the risk of miscarriage in the bed rest group versus the no bed rest group (placebo or other treatment) (relative risk (RR) 1.54, 95% confidence interval (CI) 0.92 to 2.58). Neither bed rest in hospital nor bed rest at home showed a significant difference in the prevention of miscarriage. There was a higher risk of miscarriage in those women in the bed rest group than in those in the human chorionic gonadotrophin therapy group with no bed rest (RR 2.50, 95% CI 1.22 to 5.11). It seems that the small number of participants included in these studies is a main factor to make this analysis inconclusive. AUTHORS' CONCLUSIONS: There is insufficient evidence of high quality that supports a policy of bed rest in order to prevent miscarriage in women with confirmed fetal viability and vaginal bleeding in first half of pregnancy.

Tuesday, March 28, 2006 01:40 PM

The Iraqis should talk to South Korea,

the US was fiddling with Korean leadership for decades - there's fairly solid evidence of US acquiescence in the Pak Chunghee assassination, Syngman Rhee resigned within hours of a conversation with the US ambassador, Rhee's opponent Kim Ku was slain with US permission, and even further back, Japan checked with Teddy Roosevelt before taking over the country, and Teddy basically said, sure, it's a mess, you guys could do a much better job running the place. ~sigh~

Wednesday, March 29, 2006 09:56 AM
Original article: What else we're reading

Hooray! Someone in American media finally noticing Han Myoungsook

being named prime minister. Even if with a link to korean media. Coupla things got left out, so I'll mention them - Han served not only a legislator, but as a cabinet minister - once under President Noh, and once under his predecessor, President Kim. The prime minister post is considered the equivalent of US vice-president (since Korea has no VP), but with more (official) power. Han is expected to be a prominent and influential PM, at least in part because of Pak Kunhye's leadership of the opposition GNP party - Ms. Pak is a charismatic and influential politician who is being touted as a candidate for president, although she's been quietly bringing the GNP more towards the center.

Han did indeed spend a year in prison for protesting the military dictatorships; her husband spent 14 years. Both are Quakers and active members of the Seoul Monthly Meeting of Friends, home meeting for the great Korean philosopher, activist, and Nobel Peace Prize candidate, the late Hahm Sokhon

http://www2.gol.com/users/quakers/queen_of_suffering.htm

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