Preventing Low Birthweight

Despite recent declines in infant mortality, the rates of low birthweight deliveries in the United States continue to be high. Part I of this volume defines the significance of the problems, presents current data on risk factors and etiology, and reviews recent state and national trends in the incidence of low birthweight among various groups. Part II describes the preventive approaches found most desirable and considers their costs. Research needs are discussed throughout the volume.

Despite recent declines in infant mortality, the rates of low birthweight deliveries in the United States continue to be high. Part I of this volume defines the significance of the problems, presents current data on risk factors and etiology, and reviews recent state and national trends in the incidence of low birthweight among various groups. Part II describes the preventive approaches found most desirable and considers their costs. Research needs are discussed throughout the volume.

Prenatal care programs have proven effective in improving birth outcomes and preventing low birthweight. Yet over one-fourth of all pregnant women in the United States do not begin prenatal care in the first 3 months of pregnancy, and for some groupsâ€"such as black teenagersâ€"participation in prenatal care is declining. To find out why, the authors studied 30 prenatal care programs and analyzed surveys of mothers who did not seek prenatal care. This new book reports their findings and offers specific recommendations for improving the nation's maternity system and increasing the use of prenatal care programs.

Each year more than 4 million children are born with birth defects. This book highlights the unprecedented opportunity to improve the lives of children and families in developing countries by preventing some birth defects and reducing the consequences of others. A number of developing countries with more comprehensive health care systems are making significant progress in the prevention and care of birth defects. In many other developing countries, however, policymakers have limited knowledge of the negative impact of birth defects and are largely unaware of the affordable and effective interventions available to reduce the impact of certain conditions. Reducing Birth Defects: Meeting the Challenge in the Developing World includes descriptions of successful programs and presents a plan of action to address critical gaps in the understanding, prevention, and treatment of birth defects in developing countries. This study also recommends capacity building, priority research, and institutional and global efforts to reduce the incidence and impact of birth defects in developing countries.

The increasing prevalence of preterm birth in the United States is a complex public health problem that requires multifaceted solutions. Preterm birth is a cluster of problems with a set of overlapping factors of influence. Its causes may include individual-level behavioral and psychosocial factors, sociodemographic and neighborhood characteristics, environmental exposure, medical conditions, infertility treatments, and biological factors. Many of these factors co-occur, particularly in those who are socioeconomically disadvantaged or who are members of racial and ethnic minority groups. While advances in perinatal and neonatal care have improved survival for preterm infants, those infants who do survive have a greater risk than infants born at term for developmental disabilities, health problems, and poor growth. The birth of a preterm infant can also bring considerable emotional and economic costs to families and have implications for public-sector services, such as health insurance, educational, and other social support systems. Preterm Birth assesses the problem with respect to both its causes and outcomes. This book addresses the need for research involving clinical, basic, behavioral, and social science disciplines. By defining and addressing the health and economic consequences of premature birth, this book will be of particular interest to health care professionals, public health officials, policy makers, professional associations and clinical, basic, behavioral, and social science researchers.

Each year in the United States, 250,000 infants are born too soon, weighing too little. For these low birth weight, premature infants, the future is uncertain, since they are at risk for a variety of serious medical and developmental problems—including behavioral and learning disorders that may have damaging effects for the rest of their lives. The extent to which a comprehensive early intervention program could improve or prevent these adverse outcomes was examined in the Infant Health and Development Program, a randomized controlled trial involving almost 1,000 infants in eight cities in the United States. This book describes in detail the program, its research methodology, the progress of the program, and the results of the clinical trial. The program was administered by an interdisciplinary team composed of physicians, biostatisticians, child development specialists, and researchers from several disciplines. It was instituted upon the discharge of the infants from the neonatal nursery and was maintained for three years. One-third of the infants were randomly assigned to an intervention group, the remainder to a follow-up group. Infants in both groups received pediatric care and community referral services, but only those in the intervention group participated in a program that included extensive home visits, attendance at a child development center, and group meetings for parents. The results of the program proved to be clinically important; at age three, the children in the intervention group had significantly higher IQ scores, greater cognitive development, and fewer behavioral problems. The implications of the findings for public policy are equally important, for there is increasing interest in the prevention, early detection, and management of developmental disabilities in children, as evidenced by such legislation as the Education for All Children Act. Strategies to minimize the problems of low birth weight children, with their potential for long-term savings through the prevention of disabilities and their attendant costs, could have significant repercussions in such governmental areas as medical care, education, and social welfare.

Presents country, regional and global estimates of low birthweight for 2000, together with a detailed description of the methodology used. Some limited data on trends are also included.