RISKS OF A COMPLICATED PREGNANCY DURING RESIDENCY

Objective: To determine, through a review of published articles, whether a higher prevalence of pregnancy complications is associated with residency in medicine. Data sources: Articles published between January 1980 and December 1992 found through a MEDLINE search using the MeSH terms ''pregnancy complications'' and ''internship and residency'' and through a review of the bibliographies of articles found. Study selection: Of the 17 articles found, 6 contained data on the prevalence of pregnancy complications in residents. Data extraction: The methodologic quality of the studies was evaluated systematically with the use of a grid. Data on the prevalence of the six most common pregnancy complications were retained. Data synthesis: Four of the six articles had methodologic weaknesses (missing or inappropriate control groups, poorly controlled historical bias). The best study showed a higher prevalence of premature labour, pre-eclampsia and voluntary abortion in the residents than in the control subjects. Conclusions: It is difficult to draw definitive conclusions from a single study that met the criteria for methodologic quality. More and better-controlled studies involving larger numbers of subjects are needed.