Pregnancy and childbirth are associated with significant physiologic changes and potential short- and long-term health consequences, often generating questions from patients. Physicians may benefit from trusted resources that offer clear, evidence-based explanations to common questions and support informed, shared decision-making.
The JAMA Network® has published Patient Pages since 1998 to distill high-quality evidence and make it more accessible for patient education and help guide patient decisions. Patient Pages provide a basic definition of the condition or issue, along with symptoms, consequences, diagnosis, treatment and prevention. These resources, illustrated by JAMA medical illustrators, are always freely accessible online.
As part of a series of news articles curating these outstanding resources, the AMA is highlighting free, recently published Patient Page resources of highest relevance to internists and other physicians. This article highlights resources relevant to pregnancy and childbirth.
AMA members can explore a range of peer-reviewed research and clinical information published by the JAMA Network, which brings JAMA® together with JAMA Network Open and 11 specialty journals. Published continuously since 1883, JAMA is one of the most widely circulated, peer-reviewed, general medical journals in the world. If you are a member or interested in becoming one, learn how to access these educational materials and innovative tools.
“Over-the-Counter Progestin-Only Oral Contraceptives”
- This JAMA Patient Page describes progestin-only oral contraceptive pills, which recently have been approved to be sold over the counter. From the Patient Page: “Over-the-counter oral contraceptives are birth control pills that can be obtained without a prescription.”
- The Patient Page explains that oral contraceptives “are pills that prevent pregnancy. Most oral contraceptive pills contain two hormones—estrogen and progestin—that are naturally present in the bodies of individuals who are capable of becoming pregnant. Progestin-only oral contraceptive pills can be used by individuals who should avoid additional estrogen, such as those who smoke, are breastfeeding or have heart disease or diabetes.”
“Early Pregnancy Loss”
- This JAMA Patient Page describes the causes, risk factors, diagnosis and management of early pregnancy loss. From the Patient Page: “Early pregnancy loss is the spontaneous loss of a pregnancy during the first trimester.
- “Early pregnancy loss occurs in about one of three pregnancies and affects approximately 1 million pregnant individuals each year in the U.S.”
- The Patient Page also summarizes the three management options for patients with early pregnancy loss who do not have vaginal bleeding or signs of infection:
· Expectant management.
· Medication management.
· Procedural or surgical management.
“Folic Acid to Prevent Neural Tube Defects”
- This JAMA Patient Page describes the pros and cons of folic acid supplementation during pregnancy to lower risk of fetal neural tube defects. From the Patient Page: “Folic acid deficiency is the primary preventable cause of neural tube defects.”
- The Patient Page also explains that neural tube defects are “malformations of the cranium (brain and skull) or spine (spinal cord and backbone) that can occur in fetuses during early pregnancy. These malformations occur when the neural tube, an important embryonic structure, does not close properly. The two major types of neural tube defects are anencephaly (affected infants are born without parts of their brain or skull) and spina bifida (part of the spinal cord protrudes through an opening in the back)."
“Screening for Iron Deficiency and Iron Deficiency Anemia During Pregnancy”
- In this JAMA Patient Page, the U.S. Preventive Services Task Force (USPSTF) provides a guide to screening for breast cancer. From the Patient Page: “We all want better ways to find breast cancer early and save lives from this disease. Breast cancer screening can help to detect cancer early, when it’s most treatable. This guide is meant to help you and your health care professional understand the benefits and risks of breast cancer screening, including what age to start screening and how often people should be screened. This guide is not for women who have a BRCA gene variant, [who have] a history of chest radiation or who have had breast cancer. These women should talk to their health care professional about how best to stay healthy.”
“Behavioral Counseling Interventions to Support Breastfeeding”
- This JAMA Patient Page describes breastfeeding patterns in the U.S. and behavioral counseling interventions to support breastfeeding. From the Patient Page: The USPSTF “reviewed studies about behavioral counseling to support breastfeeding during pregnancy and after childbirth.
- “The recommendation statement considered breastfeeding as feeding at the breast or with a bottle containing breast milk. Few studies of interventions included in the USPSTF review examined the direct health effects of breastfeeding. But other research has shown that breastfeeding can reduce infants’ risk of acute otitis media, asthma, weight gain and obesity, childhood leukemia and type 1 diabetes. Prior studies have also shown that breastfeeding can reduce mothers’ risk of breast and ovarian cancers, hypertension and type 2 diabetes."
“What Parents Should Know About Returning to Work While Breastfeeding”
- This JAMA Patient Page describes the challenges of returning to work while breastfeeding, tips on how to transition back to work, and the advantages of breast milk. From the Patient Page: “Breastfeeding can be a joyful experience.
- “Breastfeeding is best because of its positive effects on the health and well-being of both mother and child, and the American Academy of Pediatrics recommends breastfeeding alone for six months and with solid foods for two years if desired. However, this becomes more challenging if the mother returns to work, either inside or outside the home.”
“What is Perinatal Depression?”
- This JAMA Patient Page describes perinatal depression screening and diagnosis and available treatment options. From the Patient Page: “Perinatal depression can occur during pregnancy and the first 12 months after childbirth.
- “Perinatal depression, also called postpartum depression, affects about one in seven perinatal individuals. More than 75% of these individuals receive no treatment for perinatal depression. Onset of perinatal depression may occur prepregnancy or may develop over the course of pregnancy and the postpartum period. Untreated perinatal depression is associated with an increased risk of suicide and has additional negative effects on the perinatal individual, the fetus (preterm birth, low birth weight) and the child (impaired attachment, which may affect neurodevelopment) and may negatively affect relationships with partners and other family members.
In addition to the Patient Page feature, here are other ways physicians can leverage resources from the JAMA Network to help them in their clinical practice:
- Take CME courses and earn AMA PRA Category 1 Credit™.
- Fulfill maintenance of licensure (MOL) and CME requirements on JN Learning™, the home for all JAMA Network CME.
- Read concise summaries of clinical guidelines and recommendations in a format designed for today’s busy physicians.
The subscription cost of JAMA is included with your AMA membership, plus unlimited digital access to all JAMA Network journals, including JAMA Cardiology, JAMA Dermatology, JAMA Internal Medicine, JAMA Network Open, JAMA Neurology, JAMA Oncology, JAMA Ophthalmology, JAMA Otolaryngology–Head and Neck Surgery, JAMA Pediatrics, JAMA Psychiatry and JAMA Surgery.
The journals include many helpful features for students, residents and fellows, including full-text PDFs, clinical challenges, archived editions, audio and video author interviews where authors give their perspectives on a study’s objectives, findings and implications.
